Summary of evidence and Expert Committee recommendations
Azithromycin was added to the core list of the first EMLc in 2007 for the treatment of trachoma.
As pneumonia is one of the major causes of morbidity and mortality, the Secretariat commissioned a review of antibiotics for the treatment of upper and lower respiratory tract infections. The EMLc Subcommittee considered the reviews for each of the antibiotics in the relevant Sections.
The clinical data summarized in the review suggest that there is no evidence for superiority of azithromycin versus erythromycin (or clarithromycin) or beta lactams. It would therefore seem appropriate to continue to restrict use to the currently specified indication of trachoma, noting that it is not licensed for this purpose and the Cochrane review on this topic is inconclusive regarding the value of antibiotics.