Why isn’t azithromycin supposed to be given to infants? I thought it was safe because of its low levels of side effects.

Azithromycin (Zithromax) is a fairly new antibiotic with few side effects. It can be effective in the treatment of ear infections, throat infections, tonsillitis, bronchitis, skin infections, and some sexually transmitted diseases. Azithromycin (Zithromax) has become very popular because it is pleasant to take and very convenient (once daily dosing for 5 days). Fewer than 1% of those taking azithromycin stop taking it because of problems with side effects. Most of these side effects are quite minor, but it has been reported to rarely cause a serious form of jaundice.

This is one of several reasons that azithromycin (along with erythromycin, an older antibiotic in the same class) is not recommended for use in children under 6 months of age when another antibiotic is available (see article on Pyloric Stenosis as well). Azithromycin is processed by the liver. The immature livers of infants in the first months of life are less ready to handle this, making the risk of jaundice greater. A baby is not simply a little adult, but a developing child with unique metabolic capabilities.