Additional Dental Antibiotic Tips: Azithromycin

This is not a complete list of instructions, risks, or considerations. Follow the manufacturer’s instructions and recommendations for use, as well as your provider. This is to serve as an additional source of information.

Confirm the medication on your prescription.

If this is your first time using the antibiotic, you can take your first dose in the doctor’s office and wait 20 minutes to observe for any signs of an allergic or adverse reaction (see below). Serious allergic reactions will typically appear in the first 20 minutes. 

Take 1 hour before food or 2 hours after eating.

Signs of an allergic reaction include itching/swelling (particularly of the face, tongue, or throat), hives/red patches, and/or difficulty breathing. Should symptoms present mild with no difficulty in breathing, please contact the office as soon as possible. If symptoms become severe or breathing is affected, dial 911 and seek hospitalization immediately.

Self-monitor for improvement in swelling over the first 3 days taking the antibiotic. If no improvement, suspect antibiotic resistance and contact the office.

Antibiotics alter the normal flora in the gut and increase the risk of antibiotic-induced diarrhea, such as pseudomembranous colitis from the bacteria C. difficile.  As a result, there is the chance for a superinfection to develop, usually within 5-7 days after starting the antibiotic. Please contact the office promptly if you experience abdominal cramping, stomach pain, or constant watery diarrhea. If experiencing severe symptoms such as a high fever or dehydration, discontinue the antibiotic and contact your local hospital for acute care. Do not take any anti-peristaltic or anti-diarrheal medication (such as Imodium or Pepto-Bismol) to resolve diarrhea or GI upset, as this could lead to a more serious condition.

To help avoid superinfections, take probiotics while on the antibiotic. One way is to eat approximately 5 ounces of yogurt containing live and active cultures twice a day until the the prescription is complete. An alternative is to take acidophilus or Lactobacillus acidophilus supplements if lactose intolerant.

An additional option is over-the-counter Florajen. Take 1g prior to antibiotic, follow instructions and take for duration of antibiotic, and if you have a history of GI upset, continue for 1 week after the antibiotic.

People with a history of candida infections are at a higher risk of developing an antibiotic superinfection, and are strongly advised to follow a probiotic regimen.

Do not take this medication if you have used it in the past and have experienced adverse effects (e.g., upset stomach, diarrhea, allergic reactions).

There is a risk for any antibiotic to inhibit the effect of contraceptives (“birth control”). Utilize appropriate precautions during the course of this regimen.

There is a chance for renal impairment when taking an antibiotic. Symptoms of a developing problem include three things together: a fever, a rash, and joint pain. Cease use of the antibiotic and contact the office or your doctor immediately if these develop.

Azithromycin has a specific risk for neurologic reactions, including hearing loss. Contact your provider should altered hearing develop.

Excluding complications, do not stop taking the antibiotic until the entire regimen is completed.