Azithromycin (Ophthalmic)

Classed as a macrolide antibiotic, Azithromycin ophthalmic solution is mainly used to treat eye infections.


Although there are many different types of eye infection, Azithromycin is predominantly used to treat eye infections caused by bacteria. When bacteria enters the eye, it can easily duplicate and result in an infection occurring.

If people are close to someone else who has an infection or touch contaminated surfaces and then rub their eye, they can easily transfer bacteria to their own eye. Generally considered to be highly contagious, bacterial eye infections spread fairly easily and cause a variety of symptoms.

Patients may experience itching, crusting and/or discharge from the eye when a bacterial eye infection is present. In addition to this, their eyelids may swell, appear red in color and they may suffer from excessive watering.

By killing the bacteria, Azithromycin gets rid of the infection and, as a result, symptoms begin to subside. Prescribed for children and adults, Azithromycin ophthalmic solution is an extremely effective treatment and is one of the most popular medications for treating bacterial infections of the eye.

Conditions Treated

  • Bacterial Eye Infections

Type of Medicine

  • Macrolide Antibiotic

Side Effects

Although medicines can sometimes cause side effects, this doesn't necessarily mean that the treatment won't be effective. In fact, many medications provide adequate treatment, even if some side effects occur.

When using Azithromycin ophthalmic solution, patients may experience some redness or eye irritation when it's applied. Unless severe or prolonged, this won't normally cause an issue and will be a short-lived side effect of using the medication.

Some side effects, however, should be checked by a physician. In rare cases, patients may not be able to tolerate Azithromycin ophthalmic solution and this could be indicated by the presence of more serious side effects. If patients experience any of the following when using Azithromycin, they should seek medical advice:

  • Blistering, burning, crusting, dryness, or flaking of the skin
  • Decreased vision
  • Cough
  • Blurred vision
  • Hives or welts
  • Fever
  • Headache
  • Discharge from the eye
  • Itching, scaling, severe redness, soreness, or swelling of the skin
  • Stuffy or runny nose
  • Painful irritation of the clear front part of the eye
  • Swelling of the face
  • Skin rash
  • Pain or tenderness around the eyes and cheekbones
  • Shortness of breath or troubled breathing
  • Tightness in the chest or wheezing
  • Swelling or puffiness of the eyes

Patients may also experience a loss of taste, a change in their taste buds and/or dry eyes when they're receiving treatment with Azithromycin eye solution. Typically, these are relatively mild side effects and they do not cause the patient any distress. If patients are concerned by the presence of these side effects, however, they should seek help from their medical practitioner or their pharmacist.

Patients can also report side effects to the Food and Drug Administration, if they choose to do so. They can be contacted at 1-800-FDA-1088. By reporting side effects, patients can help the FDA to build a comprehensive list of potential side-effects caused by the medication and help to reduce instances of adverse drug reactions.


As an ophthalmic solution, Azithromycin is appropriate for topical use only. Normally prescribed in a 1% sterile solution, the dosage of the drug varies depending on the patient. For most patients, the standard dose of Azithromycin ophthalmic solution is one drop in the eye twice daily for a period of two days. When applying two drops daily, the doses should be separated by a period of at least eight to 12 hours. Following this, patients are often advised to administer one drop per day for a period of five days.

It's important to note, however, that this information exemplifies a standard dose. Patients will receive specific dosage instructions for their physician and should follow these accordingly.

In most instances, the medication will be prescribed in a bottle with a built-in applicator. This applicator should not touch any surface, including the eye or eyelid. Preventing the applicator from coming into contact with anything else helps to prevent the spread of infection and ensures that germs are unable to get into the eye or the surrounding area.

When administering Azithromycin eye solution, it's important that the medication reaches the appropriate location. In order to achieve this, patients should wash their hands thoroughly and press lightly on their lower eyelid. With their head tipped back, they can then apply the solution in the space between the eye and the eyelid.

Once the medication has been applied, patients should slowly close their eye and refrain from blinking so that it can take effect. Ideally, the eye should be kept closed for one to two minutes.

Once completed, patients should place the cap back on to the bottle of Azithromycin and store it in a safe location. They should then wash their hands in order to ensure that no medication remains present.

Unless otherwise instructed, patients should use the prescribed medication for as long as it has been prescribed. Even if the infection has appeared to resolve, patients should continue to administer Azithromycin solution for the full course of treatment. This ensures that the infection has been fully cleared and helps to prevent antibiotic resistance from occurring in the future.

If patients miss a dose or forget to administer a dose of Azithromycin, they should apply the medication as soon as they remember to do so. If it is almost time for the next dose to be applied, however, the missed dose should be avoided completely. Double doses of Azithromycin eye solution are not recommended, even if a dose has been missed.


Patients should not wear contact lenses while receiving treatment with Azithromycin ophthalmic solution. Using contact lenses while administering Azithromycin may increase eye irritation and could lead to the infection spreading.

In most cases, Azithromycin should begin to take effect quickly and patients often notice their symptoms subsiding within a matter of days. If this does not happen, patients should seek advice from their doctor or physician.

In rare instances, people may suffer an allergic reaction when using Azithromycin eye solution. As with all allergic reactions, this should be treated as a medical emergency and immediate medical help should be sought. If an allergic reaction occurs, patients may experience a number of symptoms, such as:

  • Itching
  • Shortness of breath
  • Rash
  • Hives
  • Difficulty swallowing
  • Hoarseness
  • Swelling of the face, tongue, throat and/or lips

Patients may also experience skin reactions when using Azithromycin. Although this is uncommon, it does require medical intervention. If patients experience the following symptoms while taking Azithromycin, they should seek medical help:

  • Severe acne
  • Rash
  • Blistering of the skin
  • Peeling of the skin
  • Red skin lesions
  • Ulcers or sores

These skin-related symptoms may also be accompanied by a fever and/or chills. In most cases, patients should stop taking the medication and obtain advice from a medical professional if these symptoms occur.

Although Azithromycin ophthalmic solution can be prescribed to both adults and children, it is not usually given to infants under the age of one. If physicians do prescribe Azithromycin to an infant under the age of one, it's likely that they will be given a very low dose of the medication.

While no known drug interactions have been observed, patients should inform their doctor if they are taking any other medication. This includes prescribed medication, over-the-counter medicines, vitamins and supplements.

Patients should also ensure that their physician is aware of their medical history and any existing allergies before Azithromycin is prescribed.


Azithromycin eye solution is normally prescribed so that patients can administer the medication at home. This means that patients will also need to store the medicine in their home. When keeping any medicine at home, it's vital that a secure location is used. If children or pets were to access the medication, for example, they could suffer adverse effects.

Normally, Azithromycin ophthalmic solution should be kept in the refrigerator. Placing it on a high shelf or in a dedicated drawer can help to ensure that children aren't able to access the medication. Alternatively, Azithromycin may be kept at room temperature. If so, a locked medicine cabinet or lockable storage box can help to prevent anyone from gaining access to the medicine.

Azithromycin eye solution should be stored away from heat, light and moisture and the medication should not be frozen.

In most instances, the medication will have a use-by date of just 14 days. After this time, it must be disposed of. If the patient is advised to use Azithromycin solution for less than 14 days, they should dispose of it once they have administered the final dose.

When disposing of medication, however, it should not be thrown out with regular household waste. It's important that medication is disposed of carefully so that it doesn't cause harm to anyone or anything. Patients can seek help from their pharmacist when disposing of medicines.


If treated properly, bacterial eye infections rarely cause significant complications. Although eye infections are fairly common, the associated symptoms can be extremely uncomfortable. Constant eye irritation, itching and swelling can be distressing for the patient and may interfere with their daily activities.

By using Azithromycin solution, however, they can obtain fast relief from symptoms and ensure that the infection is completely eradicated from the eye or eyes. Due to its effectiveness, physicians prescribe Azithromycin on a regular basis and it is one of the most popular forms of treatment.

It should be noted, however, that Azithromycin eye solution is intended for use on eye infections which are bacterial in nature. If the infection is viral or fungal, an alternative treatment is likely to be more appropriate. Due to this, patients should be examined by their physician prior to using this medication.

If the presence of a bacterial infection is confirmed, Azithromycin ophthalmic solution is likely to provide an effective form of treatment and will benefit the vast majority of patients who are prescribed the medication.

Last Reviewed:
December 23, 2017
Last Updated:
April 03, 2018
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