Antimicrobials have become firmly established in the life of modern man. It is difficult to imagine the treatment of a serious bacterial infection without medications that can cope with its cause. By destroying pathogenic bacteria, antibiotics suppress the activity of the inflammatory process, relieve symptoms of the disease and improve the patient’s condition.
There are many antibacterial drugs, and choosing the best one among them is not an easy task. Today, doctors are increasingly turning their attention to antibiotics from the macrolide group. These medicines are effective in fighting bacterial infections where other medicines do not work. Their rapid action and good tolerability make macrolides the drugs of choice in the treatment of acute respiratory and other infections in children and adults.
Sumamed and Azithromycin are drugs from the group of macrolides. Antibiotics are similar in composition and formulation, and have similar indications and contraindications. But Sumamed is an original drug released by the manufacturing company under the terms of a patent. Azithromycin is a generic, which has the same composition, but differs in some characteristics. Read more about each drug in this article.
It is important to remember: antibacterials are sold strictly with a prescription and only by doctor’s prescription. Self-treatment with antibiotics risks developing complications!
What’s in it: content and formulation
Comparative characteristics of the drugs are presented in the table.
Antibacterial medicine – macrolide
Antibacterial drug – macrolide
The active ingredient
Form release and dosage
125 and 500 mg coated tablets;
250 mg capsules;
Powder for preparation of oral suspension 100 mg / 5 ml
Coated tablets 125 and 500 mg;
250 mg capsules
Dispensing at the pharmacy
Sumamed and Azithromycin belong to the same group of antibiotics and have the same active substance. The only difference is the price: The Israeli drug costs several times as much. This difference is explained by the fact that Sumamed is the original patented drug, while Azithromycin is only an analogue (generic).
How macrolide antibiotics work
Azithromycin, the active ingredient in both drugs, has a broad spectrum of action. An antibiotic from the macrolide-azalide group is active against a large number of common pathogens of dangerous infections:
Aerobic Gram-positive bacteria: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes;
Aerobic Gram-negative bacteria: Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila, Moraxella catarrha
- s, Pasteurella m
- tocida, Neisseria gonorrhoeae;
Anaerobic bacteria: Clostridium perfringens, Fusobacterium spp., Prevotella spp., Porphyromonas spp.;
Other bacteria: Chlamydia
achomatis, Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Mycoplasma hominis, Borre
- a burgdorfer.
Azithromycin works well against these members of the microbial world – in vitro and in real clinical practice, it is guaranteed to get rid of the disease. In a low and moderate dosage, the drug acts bactericidal – it does not kill, but only suspends the growth and development of bacteria. It binds to the 50S-subunit of microbial cell ribosomes, inhibiting production of the enzyme peptidtranslocase and inhibiting protein synthesis – the basic building block of the membrane. Bacteria can’t continue their existence, stop growing and dividing, producing toxins – and die.
At high concentrations, azithromycin acts bactericidally. It destroys pathogenic bacteria and completely suppresses further development of the infection process. This property of the antibiotic is used in clinical practice. The doctor selects the dosage of the drug taking into account the pathology detected and the expected reaction of the body.
Some bacteria are resistant to azithromycin, such as Enterococcus faeca
- si and Bacteroides fragi
- s. Sometimes other microorganisms acquire the ability to resist the antibiotic. This can be clarified after culture of the material (blood, urine, CSF) on nutrient media and reaction with a specific drug. Azithromycin is not used against resistant strains of bacteria – no effect. The doctor chooses another drug according to the sensitivity of the microorganisms.
As a side note:
In clinical practice, it is not always possible to prescribe an antibiotic after examination. It takes a long time, at least 7 days, to get the results of a bacteriological culture. All this time, the patient will be ill, and the microorganisms will multiply. To prevent the progression of the disease and the development of complications, the doctor may prescribe antibiotics without examination – taking into account the likely causative agents. But if after three days there is no effect, the drug has to be changed. This means that the chosen remedy is not suitable and the bacteria are resistant to the drug.
After oral intake, azithromycin is quickly absorbed and reaches a maximum in the blood in 2-3 hours. The bioavailability of the drug is 37% due to its passage through the liver. The drug penetrates easily through natural barriers and enters the tissues. The concentration of the antibiotic in tissues is 10-50 times higher than in blood plasma.
The elimination period of azithromycin is very long and is 30-50 hours. The therapeutic effect lasts for 5 to 7 days after taking the last tablet. It is excreted mainly through the intestine, in small amounts through the kidneys.
Evaluation of drugs effectiveness
The active ingredient in both drugs (azithromycin) is a fairly well-known antibiotic. It is the most popular drug in the macrolide group. More than 8 thousand scientific articles are devoted to azithromycin in the PubMed database. Not all of us are interested – most of the research was done in the laboratory (in vitro), but there are actual clinical trials:
In an article, a group of scientists proved: azithromycin really does prevent the development of bronchopulmonary dysplasia in premature infants. Timely prescription of the drug allows you to avoid the development of complications.
In another article it is indicated: azithromycin prevents relapse of chronic obstructive pulmonary disease. The authors recommend prescribing this antibiotic for a long and severe course of the disease.
Azithromycin has been proven to relieve bronchial asthma. It does not directly affect the frequency of attacks, but it reduces the likelihood of bacterial complications.
The use of azithromycin in urology and gynecology should not be forgotten. The Cochrane Library review article states: the antibiotic effectively handles urogenital infections in men and women. Review authors recommend azithromycin in pregnancy. The drug reliably suppresses the development of bacterial infection, is well tolerated and does not interfere with fetal development.
Russian sources position Sumamed as a drug of choice in the treatment of acute respiratory diseases in children. It rarely causes adverse reactions and quickly copes with bacterial infection.
Original or generic: what’s the difference?
Sumamed is the original drug. Teva has a patent for its production. The cost of the medicine includes not only the cost of production and distribution, but also full-scale clinical trials. Therefore, generics almost always have a proven efficacy, but are expensive and unaffordable for many patients.
Azithromycin is a generic, that is, an analogue of the original drug. A prerequisite for generic sales is proven pharmaceutical, biological and therapeutic equivalence. The generic drug must have the same composition as the original drug and have the same effect on the body.
Generics appear on the pharmaceutical market when the patent for the original drug expires – after 5 years or more. When this term expires, any company can release an analogue, but under a different name. Generics are always cheaper – they are not in clinical trials, and the costs of producing them are much lower.
The World Health Organization supports the production of generics because they make medical care more affordable. Not everyone can afford to be treated with the original Sumamed for 500-1000 rubles, while the Russian generic Azithromycin is available to almost everyone – it costs no more than 300 rubles per package. But in practice, it turns out that a cheap drug is not always effective and sometimes fails to do its job. Therefore it is necessary to replace the original with a generic drug with caution and only on the doctor’s recommendation.
Scientists at the Institute of Pharmacology of the St. Petersburg State Medical University named after M.V. Lomonosov. Academician I. l. The Pavlovs conducted a comparative analysis of the effectiveness of drugs from the macrolide group – the original and generic versions. The authors of the study paid special attention to azithromycin. They found out:
70% of generics dissolve more slowly than the original drug – and this affects bioavailability. The higher the bioavailability of the drug, the more of the active ingredient enters the tissues – and the better the effect.
Generic always has more impurities, 2 to 32%. The total amount of impurities in the generic azithromycin is 3-5 times higher than in the original medicine.
Many studies have shown a higher clinical effectiveness of Sumamed compared to the generic Azithromycin.
In conclusion, the authors plan to continue research in this direction and find new data to compare generics and original drugs.
Pattern of use
Sumamed and Azithromycin have the same indication. They are prescribed for infectious diseases caused by bacteria sensitive to the drug:
Upper respiratory tract infections: pharyngitis, sinusitis;
Lower respiratory tract infections: bronchitis, pneumonia;
Infections of the genital organs and the urinary system;
Skin and soft tissue infections;
Lyme disease in the initial stages.
Macrolides are not prescribed:
In infections caused by bacteria insensitive to the drug;
In fungal lesions;
In viral infections.
Dosing regimen is determined by the physician. He calculates the dosage taking into account the severity of the patient’s condition, the pathology detected, the presence of concomitant diseases. Tablets and capsules should be taken 1 hour before or 2 hours after a meal, without chewing and with water. The suspension is prescribed for children; the required volume of the drug is measured out using a syringe.
Important aspects of antibiotic therapy:
Take antibiotics should be strictly in the dosage specified by the doctor. Do not decrease – it will lead to the development of drug resistance. Exceeding the dosage is also dangerous and threatens the development of complications.
Therapy must be completed. If treatment is interrupted, the bacteria will become resistant to azithromycin, making it much harder to fight the infection.
Side effects of Sumamed and Azithromycin are shown in the table below. It is not known which drug is more likely to cause an adverse reaction – no clinical studies have been done on this issue.
Organs and systems
Very frequently (10%) and frequently (1-10%)
Infrequent (0.1-1%) and rare (0.01-0.1%)
Unknown frequency (insufficient data to estimate)
Blood and lymph
Leukopenia, eosinophilia, thrombocytopenia, hemolytic anemia
Dizziness, drowsiness, insomnia, paraesthesia, agitation
Anxiety, fainting, seizures, loss of smell
Sensation of palpitations, flushes of blood to the face
Decrease in blood pressure
Diarrhea, nausea, vomiting, abdominal pain
Meteorism, constipation, belching, abdominal bloating, liver dysfunction
Skin and subcutaneous tissue
Skin rash, itching, dermatitis, sweating
Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme
Kidney and urinary tract
Asthenia, facial edema, peripheral edema
Source:The official instructions for the drugs Sumamed and Azithromycin.
individual intolerance to the drug;
Severe liver dysfunction.
In pregnancy, azithromycin is prescribed with caution and only when no other treatment is available. During breastfeeding the drug is prohibited.
Sumamed and Azithromycin are antibacterial drugs from the macrolide group. They are prescribed to treat bacterial infections of the respiratory tract, urinary tract, genitals and skin.
Sumamed is the original drug. Its effectiveness has been confirmed by clinical trials.
Azithromycin is a generic. By default, it should have a similar composition and have the same therapeutic efficacy.
Sumamed and Azithromycin well tolerated. Adverse reactions if the dosage and regimen are followed are infrequent.
Antibacterials are dispensed in the pharmacy only with a doctor’s prescription. Self-treatment is dangerous to health!