Non-standard Z-Pak dosing schedule

December 8, 2018 12:00 PM

I'm about to start taking a Z-Pak (azithromycin) for a sinus infection and I thought I had read somewhere that there's a more effective dosing schedule than the standard "2 on day one, then 1 per day." Am I wrong?
posted by Johnny Wallflower to Health & Fitness (7 answers total)

I haven't heard of that, but my husband took a z pack last week for bronchitis and it is amazing how fast it worked. This is the second one for him in the past couple of years, and it always works like a miracle. The docs have never told him anything different for dosing but we are not 'in the know' so to speak. Feel better try tea and Emergencee seemed to help too.
posted by chocolatetiara at 12:22 PM on December 8, 2018 [4 favorites]

The only non-standard schedule I’ve had with z-paks and sinus infections is that my doctor usually has me take a second zpak after finishing the first one.
posted by ilovewinter at 12:31 PM on December 8, 2018

If your doctor had wanted you to use a non-standard schedule, they would have told you. In the absence of a compelling reason to deviate—which Internet People saying, "Oh yeah, I heard it works better if you do this" definitely is not—you should stick to the standard. Azithromycin is generally very quick and effective for upper respiratory infections when taken as normal, why mess with that?
posted by Anticipation Of A New Lover's Arrival, The at 12:36 PM on December 8, 2018 [4 favorites]

Best answer: There is a 500 mg x 3 days dosing schedule (Tri-Pak), which can be used for strep pharyngitis and COPD exacerbations -- not bacterial sinusitis -- but I have yet to see anything suggesting that it is more effective than the Z-Pak 5 day schedule.

Dosing schedules, especially for antibiotics, are usually carefully designed based on the drug's killing capability and the likelihood of inducing resistance, so don't mess with them unless your doctor and pharmacist both tell you to.

(Obviously, this is not medical advice, except for the part about antibiotic resistance, I am totally ok with calling that medical advice if it helps avoid another nightmare bacteria.)
posted by basalganglia at 1:16 PM on December 8, 2018 [9 favorites]

Best answer: I was just about to say what basalganglia said. You're probably thinking of 500mg daily x3 days.

According to this the 5 day vs the 3 day is basically identical so go with the 5 day as prescribed.
posted by selfmedicating at 1:22 PM on December 8, 2018 [1 favorite]

Response by poster: Thanks, all! I'm sticking with the standard regimen.
posted by Johnny Wallflower at 1:36 PM on December 8, 2018 [1 favorite]

FYI, I took a Z pack for a sinus infection and it didn't heal it -- and then I spoke with a specialist and she told me that Z packs are only about 40% effective for infections above the neck (aka sinus). So you might want to explore Amoxicillin or another type of antibiotic. Good luck!
posted by knownassociate at 8:13 AM on December 10, 2018