Can dogs take azithromycin?

In this article:

• What is azithromycin used for in dogs?
• Is azithromycin safe for dogs?
• Azithromycin dosage for dogs
• Azithromycin alternatives for dogs
• Summary

In this article

• What is azithromycin used for in dogs?
• Is azithromycin safe for dogs?
• Azithromycin dosage for dogs
• Azithromycin alternatives for dogs
• Summary

Azithromycin is a broad-spectrum antibiotic that fights several types of bacterial infections in dogs. People may know azithromycin better as the brand-name Zithromax. Even though it’s a familiar drug, it’s not approved by the U.S. Food and Drug Administration (FDA) for use in dogs. Even so, veterinarians consider it a safe and effective antimicrobial treatment in dogs. Azithromycin only requires a few days to eradicate an infection, so dogs experience minimal side effects.

RELATED: Save up to 80% on azithromycin

What is azithromycin used for in dogs?

Veterinarians use azithromycin in dogs to treat bacterial infections and, in combination with the antiparasite drug atovaquone, to treat babesiosis, a tick-borne parasite infection.

Bacterial infection

Azithromycin can be used in dogs to treat any infection caused by bacteria vulnerable to azithromycin. Some of these bacteria species are familiar to most people, like “staph” infections (Staphylococcus), “strep” infections (Streptococcus), and Bordetella, a common respiratory infection in dogs and cats. Other types of azithromycin–susceptible bacteria, such as Helicobacter, Mycoplasma, or Borrelia (Lyme disease), are well-known to veterinary professionals. 

These azithromycin–susceptible bacteria can cause canine infections in the nose, sinuses, and throat (upper respiratory tract infections), infections of the lungs (pneumonia and bronchitis), skin, blood, digestive system, abdomen, and the urinary and genital tracts. Veterinarians could use azithromycin for any of these infections, though it’s not always their first choice.

Azithromycin does not kill bacteria like some antibiotics do. As a macrolide antibiotic, it prevents bacteria from making proteins that help bacteria grow and spread. It’s a bacteriostatic drug. It “halts” a bacterial infection in place while the immune system does the rest. Erythromycin was the first macrolide antibiotic. Azithromycin is a slightly different version of that drug that should have fewer side effects in a dog. 

One reason veterinarians apply the use of azithromycin in dogs is that it’s well-absorbed (about 97% of the dose gets into the dog’s bloodstream), and it lasts a long time in the dog’s tissues. After five days of dosing, azithromycin’s half-life in dogs is about 90 hours. Another advantage of azithromycin is that it collects in white blood cells, the infection-fighting cells that crowd around an infection. In a sense, the immune system delivers the drug where it’s needed. Azithromycin also collects in the lung tissues, making it a good choice for lung infections.

Babesiosis

Babesiosis is a parasite infection of the blood rarely found in the United States. It most commonly occurs in the southeastern U.S. and Texas. Babesiosis is thought to be spread by ticks and dogfights. The combination of azithromycin and the antiparasite drug atovaquone is the only drug treatment proven to reduce the infection to undetectable levels in the blood.

Is azithromycin safe for dogs?

Veterinarians consider azithromycin safe for dogs. 

Dogs who are allergic to azithromycin or any other macrolide antibiotic cannot safely take azithromycin. Veterinarians may be reluctant to use it in dogs with liver disease because the dog is more likely to experience potential side effects.

Side effects of azithromycin in dogs

The most common side effects of azithromycin in dogs are:

• Vomiting
• Abdominal discomfort
• Loss of appetite
• Diarrhea

In animals, the most serious side effects include:

• Liver dysfunction
• Allergic reactions (angioedema)
• Abnormal or fast heartbeats 
• Reduced kidney function

Call a veterinarian if you notice signs of a potentially serious side effect of azithromycin, such as:

• Yellowing of the dog’s eyes, gums, or skin
• Swelling of the dog’s mouth, face or throat
• Trouble breathing or wheezing
• Repeated vomiting and lack of appetite that persists over 24 hours

Interactions of azithromycin with other pet meds

In people, azithromycin has many documented and theoretical drug interactions. These may or may not be true in dogs as well, so make sure the veterinarian knows about all the prescription medications, over-the-counter drugs, alternative remedies, and supplements the dog is being given, especially:

• Other macrolide antibiotics 

These are typically drugs that end in “-mycin,” like erythromycin.

• The heartburn and ulcer medication cisapride 

Cisapride is never used with azithromycin in people.

• Antacids

Oral antacids will reduce the effectiveness of the azithromycin dose.

• The immune suppressant cyclosporine

Azithromycin may increase the concentration and side effects of cyclosporine.

• Blood thinners

Drugs like warfarin might be more likely to cause bleeding episodes in a dog on azithromycin.

Azithromycin dosage for dogs

Plumb’s Veterinary Drug Manual recommends the following azithromycin dosages:

• For infections due to susceptible bacteria: 5–10 mg/kg once daily for 3–7 days 
• For skin infections: 10 mg/kg once daily for 3 days, repeating weekly until infection has resolved
• For babesia: 10 mg/kg once per day with atovaquone 13.3 mg/kg every 8 hours for 10 days 

Veterinarians may use other doses depending on their experience.

There are no azithromycin products formulated for dogs, so pet owners will rely on human formulations or customized products from a compounding pharmacy. 

Can dogs overdose on azithromycin?

Doses can vary between veterinarians. The highest recommended dosage is 15 mg per kilogram of body weight, taken once daily. High doses are likely to cause vomiting in dogs. Call the veterinarian or take the dog to a veterinary hospital if a dog ingests too much azithromycin for any reason. 

Can I give my dog azithromycin every day?

When a veterinarian prescribes azithromycin, give the dog a dose every day for the entire duration prescribed. Even if the dog feels better, the daily dose is required to make sure the infection is eliminated. Veterinarians consider azithromycin safe to take daily because it’s only required for a few days. Treatment rarely lasts beyond 10 days except for very severe infections.

How to give your dog azithromycin

Although azithromycin is a short-term treatment, it’s important that the dog gets every dose. Missing a dose increases the risk of the infection coming back to life or, worse, developing drug resistance. It’s important to get it right, so use the following tips to make sure that the dog gets all the medicine it needs:

• • Follow all the veterinarian’s instructions. 
  • Do not change the dose or dosing schedule. 
  • NEVER miss a dose. If you do, give the missed dose when remembered unless it’s almost time for the next dose.

• How to give a dog azithromycin tablets:

• • • It’s best to give the dog azithromycin tablets with food.
    • A veterinary technician or other veterinary professional can demonstrate the proper technique to give a dog a pill. You can also use a pill plunger.
    • Store azithromycin tablets at room temperature.

• How to give a dog azithromycin oral suspension:

• • The dog should have an empty stomach when getting a dose of azithromycin oral suspension.
  • Shake the bottle well before measuring each dose. 
  • Measure doses using a calibrated oral syringe. Don’t use kitchen utensils. If you don’t have a calibrated oral syringe, the veterinarian or a pharmacist can provide one.
  • If you don’t know the proper technique for administering liquid medicine to a dog, ask a veterinary professional to demonstrate.
  • Do not refrigerate the oral suspension. Store it at room temperature for up to 10 days. After 10 days, throw the medicine away.

Azithromycin alternatives for dogs

Veterinarians can prescribe azithromycin to dogs, but there are other antibiotics to choose from. For many infections, antibiotics other than azithromycin are usually their first choice. These include:

• Penicillin antibiotics such as amoxicillin-clavulanate
• Tetracyclines such as doxycycline
• Fluoroquinolones such as enrofloxacin
• Other macrolide antibiotics

If using azithromycin isn’t possible or doesn’t work, veterinarians can switch to one of these other treatment options if appropriate.

If the dog is not very sick or doesn’t have a fever, it may be possible to take care of the dog at home. Dogs can fight off mild infections just as people do. Before using any home treatment, talk to a veterinarian first. If you do treat a dog at home, take the dog to a veterinarian if symptoms worsen. Possible home remedies include:

• Adequate nutrition
• Probiotics
• Cleaning and antiseptics for skin infections
• Veterinarian-recommended home remedies 

Summary

Although veterinarians don’t always consider azithromycin a first choice, it is a safe and effective antibiotic for use in dogs with bacterial infections. It will not work for other types of infections, such as viral or fungal infections. For azithromycin to work, give the dog one dose daily for the full duration of treatment.