Roxithromycin

Roxithromycin

Roxithromycin is a semi-synthetic macrolide antibiotic derived from erythromycin that is used to treat various bacterial infections. It is structurally and pharmacologically similar to other macrolide antibiotics like erythromycin, azithromycin, or clarithromycin. Roxithromycin is a semi-synthetic derivative of erythromycin modified to improve its antimicrobial activity. 

Roxithromycin Uses

Roxithromycin is a macrolide antibiotic primarily used to treat various bacterial infections. It exhibits a broad spectrum of action against a wide range of pathogens, thus making it a versatile treatment option, including:

Respiratory Tract Infections: Roxithromycin is commonly given by the doctors for respiratory tract infections, including:

• Bacterial infections of the tonsils (Tonsillitis)
• Sinus infections (Sinusitis)
• Inflammation of the bronchial tubes (Bronchitis)
• Pneumonia 

Skin and Soft Tissue Infections:

• Impetigo (a highly contagious skin infection)
• Cellulitis (bacterial skin infection)
• Erysipelas 

Urinary Tract Infections:

• Roxithromycin can be used to treat urinary tract infections (UTIs), including infections of the kidneys, bladder, ureters, and urethra.

How to Use Roxithromycin

The recommended adult dosage of roxithromycin tablets is 300 mg daily, once or twice in divided dosages. 

However, the dosage may vary based on the individual's condition and response to the medication. The doctor will determine the appropriate dose.
Dosage for Children

The dosage for children is dependent on their weight, and the doctor will provide the exact dosage instructions. The recommended dosage for children weighing more than 40 kilograms is one 150 mg tablet twice daily. 

Administration

Roxithromycin tablets should be taken at least fifteen minutes before eating anything or on an empty stomach (more than three hours after a meal). This medication works best when taken on an empty stomach. Swallow the tablets whole with a glass of water.

Duration of Treatment

Doctors typically prescribe roxithromycin for 5 to 10 days to treat infections. However, the duration may be longer, depending on the condition and clinical response. The doctor may prescribe roxithromycin for extended periods if necessary.

Missed Dose

If you missed a dose, take it as soon as possible. However, if it is time for your next dose, take the next scheduled dose. Do not take a double dose to make up for the missed one.

Side Effects of Roxithromycin Tablet

Like all medications, roxithromycin tablets can cause side effects. While most roxithromycin side effects are minor and temporary, some may require medical attention. Here are some common side effects of roxithromycin tablets:

• Vaginal thrush
• Nausea, vomiting, abdominal pain, diarrhoea, and decreased appetite
• Skin rash
• Headache

Serious Side Effects: Immediately call your doctor if you notice any of the following, mainly if they occur several weeks after stopping roxithromycin treatment:

• Gastrointestinal Related: Severe or persistent diarrhoea, abdominal cramps, bloody stools
• Infection Related: Oral thrush, vaginal infection, or other new infection
• Allergy-related: Difficulty breathing, swelling of the face, lips, tongue or throat, or severe skin rash
• Skin Related: Severe skin rash, skin peeling, blistering

How Roxithromycin Works

Roxithromycin works by preventing bacterial growth by interfering with their protein synthesis. 

Mechanism of Action

Roxithromycin binds to the 50S subunit of bacterial ribosomes, preventing the synthesis of vital proteins required for bacterial growth and survival. By inhibiting protein synthesis, Roxithromycin effectively stops the bacteria from multiplying and spreading.

Antibacterial Spectrum

Roxithromycin exhibits a broad antibacterial spectrum in vitro, targeting various bacterial strains, including:

• Streptococcus agalactiae
• Streptococcus pneumoniae (Pneumococcus)
• Neisseria meningitidis (Meningococcus)
• Listeria monocytogenes
• Mycoplasma pneumoniae
• Chlamydia trachomatis
• Ureaplasma urealyticum
• Legionella pneumophila
• Helicobacter (Campylobacter)
• Gardnerella vaginalis
• Bordetella pertussis
• Moraxella catarrhalis (Branhamella Catarrhalis)
• Haemophilus ducreyi

Notably, roxithromycin is more effective against certain gram-negative bacteria, particularly Legionella pneumophila, compared to other macrolide antibiotics.

Can I take Roxithromycin with Other Medicines?

Roxithromycin can interact with certain medications, so informing your doctor or pharmacist about all your ongoing medicines, including prescription, over-the-counter, herbal, and dietary supplements, is essential. It will help them assess potential interactions and provide appropriate guidance.

The following are some common interactions to be aware of:

• Antacids: Antacids containing aluminium or magnesium can reduce the absorption of roxithromycin, making it less effective. Taking roxithromycin at least 2 hours before or after taking antacids is advisable.
• Digoxin: Roxithromycin may increase digoxin levels, a medication used to treat heart conditions, leading to potential side effects. 
• Theophylline: Roxithromycin can increase the levels of theophylline, a medicine used to treat respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). 
• Warfarin: Roxithromycin may enhance warfarin's anticoagulant effect, increasing the risk of bleeding. 
• Ergot alkaloids: Roxithromycin can increase the levels of ergot alkaloids, medications used to treat migraines and certain types of headaches, potentially leading to adverse effects.
• Cyclosporine: Roxithromycin may increase the levels of cyclosporine (a medicine used by doctors to prevent organ transplant rejection), potentially causing toxicity.

It is essential to disclose all ongoing medications, including over-the-counter drugs, vitamin or mineral supplements, and herbal products, to your doctor to ensure safe and effective treatment with roxithromycin tablets.

Dosing Information

The recommended dosage of roxithromycin tablets for adults is 300 mg per day. Your doctor may recommend 150 milligrams twice a day for atypical pneumonia. The usual treatment duration is five to ten days, depending on the indication & clinical response. The treatment of Streptococcal throat infections require at least ten days of therapy, and a small proportion of patients with non-gonococcal genital infections may require 20 days for a complete cure.

Paediatric Population

Roxithromycin is administered twice daily at a dose of 5 to 8 mg/kg/day for children. For children weighing 40 kg and over, the recommended dosage is one 150 mg tablet in the morning and evening. The usual treatment duration is five to ten days, based on the indication and clinical response. 
Doctors advise taking roxithromycin tablets at least 15 minutes before food or more than 3 hours after a meal for best absorption. 

FAQs

1. Is Roxithromycin safe?

Roxithromycin is generally well-tolerated and considered safe when taken as prescribed. In clinical trials, only 1.2% of adults and 1.0% of children discontinued treatment due to adverse reactions. However, like all medications, it can cause several side effects, some of which may require medical attention.

2. Is roxithromycin better than azithromycin?

Roxithromycin and azithromycin are both effective macrolide antibiotics but differ in pharmacokinetics and spectrum of activity. Studies comparing the antistreptococcal effects of roxithromycin and azithromycin have shown that azithromycin exhibits more pronounced effects against Streptococcus pyogenes and Streptococcus pneumoniae. Azithromycin achieved a more significant reduction in viable bacterial counts and prevented regrowth for a longer duration compared to roxithromycin.

3. Is roxithromycin stronger than amoxicillin?

Both roxithromycin and amoxicillin belong to different antibiotic classes and have different activity spectrums against various bacterial strains. The choice between them depends on the specific infection and the susceptibility of the causative pathogen.

4. Is roxithromycin used for cough?

Yes, roxithromycin can be beneficial in treating respiratory tract infections that may cause coughs, such as bronchitis, pneumonia, & acute exacerbations of chronic bronchitis.

5. Is roxithromycin good for a sore throat?

Roxithromycin effectively treats sore throats caused by bacterial infections, such as tonsillitis, pharyngitis, and streptococcal throat infections. Doctors commonly prescribe it for these conditions.

6. Can the use of Roxithromycin cause diarrhoea?

Yes, diarrhoea is one of the common side effects associated with the use of roxithromycin. In rare cases, severe or persistent diarrhoea may indicate a serious condition affecting the bowel, requiring immediate medical attention.

7. How long does Roxithromycin take to work?

The time it takes for roxithromycin to work can vary and depends on the type and severity of the infection. Improvements in symptoms may be observed within a few days of starting treatment. However, completing the antibiotics as prescribed is crucial, even if symptoms improve.

8. Can I stop taking Roxithromycin when my symptoms are relieved?

No, it is not advisable to stop taking roxithromycin once your symptoms are relieved. Stopping the medication in between may allow the remaining bacteria to survive and multiply, leading to a recurrence of the infection. It is essential to complete the entire course of antibiotics as your doctor prescribes.

9. Is Roxithromycin an antibiotic?

Yes, roxithromycin is a semi-synthetic antibiotic belonging to the macrolide family. It works by binding to bacterial ribosomes and inhibiting protein synthesis, thereby preventing bacterial growth and replication.