{"id":632879,"date":"2025-07-15T17:53:01","date_gmt":"2025-07-15T21:53:01","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=632879"},"modified":"2025-10-17T11:37:03","modified_gmt":"2025-10-17T15:37:03","slug":"azithromycin-side-effects-in-children","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/azithromycin-side-effects-in-children\/","title":{"rendered":"Azithromycin side effects in kids: What parents should know"},"content":{"rendered":"

Azithromycin<\/span><\/a> is an antibiotic used to treat certain types of bacterial infections in both adults and children. It\u2019s available as a generic drug or under the brand name <\/span>Zithromax<\/span><\/a>. In children, <\/span>the Food and Drug Administration (FDA)<\/span><\/a> has approved azithromycin to treat ear infections, throat and sinus infections, tonsillitis, and community-acquired pneumonia (a type of pneumonia caught outside of a hospital setting).\u00a0<\/span><\/p>\n

Like any medication, azithromycin can cause side effects. This can be especially concerning for parents when new symptoms appear while their child is already sick. Knowing what to expect can help you feel more prepared to support your child\u2019s recovery. In this article, we\u2019ll cover the most common side effects of azithromycin in children, what to do if they happen, and when to call your child\u2019s healthcare provider.<\/span><\/p>\n

Common azithromycin side effects in kids<\/span><\/h2>\n

The side effects of azithromycin in children are similar to the side effects of the antibiotic in adults. The most common <\/span>side effects of azithromycin<\/span><\/a> are typically digestive upset, but rashes may also occur.\u00a0<\/span><\/p>\n

\u201cWhether it\u2019s abdominal cramping, nausea, diarrhea, I pretty much expect patients to have some sort of gastrointestinal (GI) disturbance while taking azithromycin,\u201d says <\/span>Austin Shuxiao<\/span>, MD, an internal medicine specialist and founder of PeachIV in New York City. How often side effects occur can depend on what it\u2019s being prescribed for and for how long.\u00a0<\/span><\/p>\n\n\n\n\n\n\n\n\n
\n

Most common side effects of azithromycin in children, by condition<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

Condition treated<\/b><\/td>\nDiarrhea<\/b><\/td>\nAbdominal pain<\/b><\/td>\nVomiting<\/b><\/td>\nNausea<\/b><\/td>\nRash<\/strong><\/td>\n<\/tr>\n
Ear infection<\/b><\/td>\nUp to 4% (1-day course)<\/span><\/td>\nUp to 2% (3-day course)<\/span><\/td>\nUp to 5% (1-day course)<\/span><\/td>\nUp to 1% (1-day course)<\/span><\/td>\nUp to 1% (1-day course)<\/span><\/td>\n<\/tr>\n
Community-acquired pneumonia<\/b><\/td>\n6%<\/span><\/td>\n2%<\/span><\/td>\n2%<\/span><\/td>\n2%<\/span><\/td>\n2%<\/span><\/td>\n<\/tr>\n
Throat infection or tonsillitis<\/b><\/td>\n5%<\/span><\/td>\n3%<\/span><\/td>\n6%<\/span><\/td>\n2%<\/span><\/td>\n1%<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Less common, but possible, azithromycin side effects<\/span><\/h2>\n

According to its drug label, less common side effects that occur in fewer than 1% of people can present differently between children and adults.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Less common side effects of azithromycin in children vs. adults<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

System affected<\/b><\/td>\nChildren<\/b><\/td>\nAdults<\/b><\/td>\n<\/tr>\n
General<\/b><\/td>\nFever, face swelling, fatigue, fungal infection, general pain\/ discomfort<\/span><\/td>\nFatigue\u00a0<\/span><\/td>\n<\/tr>\n
Cardiovascular and blood<\/b><\/td>\nChest pain, anemia, low white blood cell count<\/span><\/td>\nPalpitations, chest pain<\/span><\/td>\n<\/tr>\n
Digestive<\/b><\/td>\nIndigestion, constipation, loss of appetite, flatulence, inflammation of the small intestine or stomach, jaundice (yellowing skin), loose stools, oral yeast infection (thrush)<\/span><\/td>\nIndigestion, flatulence, vomiting, blood in stools, jaundice<\/span><\/td>\n<\/tr>\n
Urinary and reproductive<\/b><\/td>\nNone reported<\/span><\/td>\nYeast infection, vaginal infection, kidney infection<\/span><\/td>\n<\/tr>\n
Nervous<\/b><\/td>\nHeadache, restlessness, dizziness, agitation, nervousness, trouble sleeping<\/span><\/td>\nDizziness, headache, vertigo, sleepiness<\/span><\/td>\n<\/tr>\n
Allergies<\/b><\/td>\nRash, allergic reaction<\/span><\/td>\nRash, itchiness, light sensitivity, swelling\u00a0<\/span><\/td>\n<\/tr>\n
Respiratory<\/b><\/td>\nCough, sore throat, runny nose, water buildup in the lungs\u00a0<\/span><\/td>\nNone reported<\/span><\/td>\n<\/tr>\n
Skin<\/b><\/td>\nEczema, fungal skin infection, itchiness, sweating, rash<\/span><\/td>\nNone reported<\/span><\/td>\n<\/tr>\n
Other\u00a0<\/b><\/td>\nConjunctivitis (pink eye)\u00a0<\/span><\/td>\nNone reported<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Children taking azithromycin may experience certain side effects such as flu-like symptoms, skin and oral yeast infections, digestive upset, loss of appetite, and nervous system symptoms like agitation or restlessness (also known as hyperkinesia). Some of these side effects may be more likely to occur in children than in adults. If your child develops any of these symptoms, it\u2019s a good idea to contact their healthcare provider to discuss management or possible alternative treatments.<\/span><\/p>\n

Although rare, azithromycin can also cause serious side effects in children and adults, such as liver injury, severe allergic reactions, and heart rhythm problems. \u201cAny rash, itching, or difficulty breathing in patients taking azithromycin should be treated seriously,\u201d Dr. Shuxiao says. For example, if your child has symptoms of an allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat, seek emergency medical help. Other serious side effects will also require immediate or emergency medical attention.\u00a0<\/span><\/p>\n

One rare but serious risk is a heart rhythm change called <\/span>QT prolongation<\/span><\/a>, when the heart takes longer than normal to reset between beats. This can lead to irregular heart rhythms or, in very rare cases, a heart attack (cardiac arrest). A child\u2019s risk may be higher if they have a history of heart conditions or are <\/span>taking a high dose of azithromycin<\/span><\/a>. Healthcare providers may monitor for this using an electrocardiogram (ECG), especially if there are known heart concerns. Parents can help reduce the risk by sharing their child\u2019s full medical history\u2014including a full list of medications taken\u2014with the prescribing provider.<\/span><\/p>\n

How to manage mild azithromycin side effects in children<\/span><\/h2>\n

If your child experiences mild side effects while taking azithromycin, you may be able to manage them at home. Digestive symptoms, such as nausea or upset stomach, can often be eased by adjusting meal timing and sticking to light, bland foods. Dr. Shuxiao recommends offering smaller meals and avoiding spicy or greasy foods while your child is on azithromycin.<\/span><\/p>\n

Staying well hydrated is also important. \u201cProper hydration helps the body circulate nutrients and medication to fight infection and flush out byproducts of the illness,\u201d says <\/span>Martina Ambardjieva<\/span><\/a>, MD, urologist at Dr. Telx. Hydration becomes especially important if your child is experiencing diarrhea, sweating, or fever. Consider including fluids with electrolytes, such as electrolyte powders, electrolyte drinks, or brothy soups.<\/span><\/p>\n

If digestive issues continue, your child\u2019s healthcare provider may recommend a probiotic to support gut health. \u201cAnti-diarrheals like <\/span>loperamide<\/span><\/a> can also be used if symptoms become too bothersome,\u201d Dr. Shuxiao adds. Always contact your child\u2019s healthcare provider before starting new medications or supplements.<\/span><\/p>\n

Azithromycin alternatives for children<\/span><\/h2>\n

If your child experiences side effects while on azithromycin, their healthcare provider may consider switching to an <\/span>alternative medication<\/span><\/a>, if appropriate. Here are some options, sorted by the type of antibiotic.<\/span><\/p>\n

Macrolide antibiotics<\/span><\/h3>\n

Azithromycin is a <\/span>macrolide antibiotic<\/span><\/a> that stops the growth of bacteria. This class of drugs is typically used for respiratory infections and <\/span>infections caused by streptococcus bacteria<\/span><\/a>, like <\/span>strep throat<\/span><\/a> or <\/span>tonsillitis<\/span><\/a>. Other macrolides that can be prescribed in place of azithromycin include <\/span>clarithromycin<\/span><\/a> and <\/span>erythromycin<\/span><\/a>.<\/span><\/p>\n

Penicillin antibiotics<\/span><\/h3>\n

Penicillin antibiotics<\/span><\/a> are a subtype of beta-lactam antibiotics that can be used for a wide range of infections, including infections caused by streptococcus bacteria. Examples of penicillins that may be prescribed include <\/span>amoxicillin<\/span><\/a> and ampicillin. <\/span>Augmentin<\/span><\/a> is another example of an antibiotic that contains a combination of amoxicillin and clavulanate, a beta-lactamase inhibitor, which helps amoxicillin work against resistant bacteria.\u00a0<\/span><\/p>\n

Children who are allergic to penicillin drugs are often prescribed <\/span>macrolide antibiotics<\/span><\/a> instead, since they work for similar infections.\u00a0<\/span><\/p>\n

Cephalosporin antibiotics<\/span><\/h3>\n

Cephalosporin antibiotics<\/span><\/a> are another type of beta-lactam antibiotic that is used to kill bacteria. These drugs are used to treat certain types of bacterial skin and respiratory infections. Examples include <\/span>cefaclor<\/span><\/a>, <\/span>cephalexin<\/span><\/a>, and <\/span>cefuroxime<\/span><\/a>.<\/span><\/p>\n

Because they are similar to penicillins, people with penicillin allergies may also react to <\/span>cephalosporin<\/span><\/a> antibiotics. A healthcare provider can decide whether it\u2019s safe for someone with a penicillin allergy to take a cephalosporin or whether they should avoid both types of antibiotics.<\/span><\/p>\n

Tetracycline antibiotics<\/span><\/h3>\n

Tetracycline antibiotics<\/span><\/a> stop the growth of bacteria. These drugs are used in older children for skin infections, acne, and certain other infections. Healthcare providers may prescribe <\/span>doxycycline<\/span><\/a> or <\/span>tetracycline<\/span><\/a> as alternatives to azithromycin, especially in those with allergies to macrolides.<\/span><\/p>\n

When to see your healthcare provider<\/span><\/h2>\n

Parents should reach out to their child\u2019s healthcare provider if they notice any severe or persistent side effects while their child is taking azithromycin. While some digestive upset is common, certain side effects may require medical attention. \u201cParents should be instructed to seek medical advice if their child experiences persistent vomiting, severe diarrhea, skin rash, jaundice, fatigue, or respiratory difficulty. These may be signs of an adverse or allergic reaction requiring discontinuation or alternative treatment,\u201d Dr. Ambardjieva says.<\/span><\/p>\n

It\u2019s also important to watch for signs of more serious side effects, such as allergic reactions, liver problems, or heart-related symptoms. \u201cWhile mild gastrointestinal upset or low energy may be expected during treatment, symptoms such as itching rash, facial swelling, or signs of liver or heart involvement (e.g., jaundice, palpitations) are not typical and should prompt medical evaluation,\u201d Dr. Ambardjieva says.\u00a0<\/span><\/p>\n

Because children may experience a broader range of side effects than adults, it\u2019s a good idea to check in with your child\u2019s healthcare provider if new symptoms appear. When you call, be ready to share details like when doses were given, whether the medication was taken with food, and when symptoms began. This can help the provider identify the cause and decide on the next steps. And if you cannot reach your child\u2019s healthcare provider right away\u2014or if symptoms are serious or concerning\u2014it\u2019s best to go right to the nearest emergency room.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Azithromycin is an antibiotic used to treat certain types of bacterial infections in both adults and children. It\u2019s available as a generic drug or under the brand name Zithromax. In children, the Food and Drug Administration (FDA) has approved azithromycin to treat ear infections, throat and sinus infections, tonsillitis, and community-acquired pneumonia (a type of […]<\/p>\n","protected":false},"author":149,"featured_media":632880,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[715,3564,12752],"coauthors":[21072],"class_list":["post-632879","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-antibiotics","tag-children","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"\nAzithromycin side effects in kids: What parents should know<\/title>\n<meta name=\"description\" content=\"Discover the most common azithromycin side effects in kids, including stomach upset, rashes, and allergic reactions. 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