It is used to treat diverse infections, including:

• Prevention and treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease due to H. influenzae, M. catarrhalis, or S. pneumoniae. The benefits of long-term prophylaxis must be weighed on a patient-by-patient basis against the risk of cardiovascular and other adverse effects
• Community acquired pneumonia due to C. pneumoniae, H. influenzae, M. pneumoniae, or S. pneumoniae
• Uncomplicated skin infections due to S. aureus, S. pyogenes, or S. agalactiae
• Urethritis and cervicitis due to C. trachomatis or N. gonorrhoeae. In combination with ceftriaxone

Azithromycin is part of the United States Centers for Disease Control-recommended regimen for the treatment of gonorrhea. It is active as monotherapy in most cases, but the combination with ceftriaxone is recommended based on the relatively low barrier to resistance development in:

• gonococci and due to frequent co-infection with C. trachomatis and N. gonorrhoeae
• Trachoma due to C. trachomatis
• Genital ulcer disease (chancroid) in men due to H. ducrey
• Acute bacterial sinusitis due to H. influenzae, M. catarrhalis, or S. pneumoniae. Other agents, such as amoxicillin/clavulanate are generally preferred, however
• Acute otitis media caused by H. influenzae, M. catarrhalis or S. pneumoniae. Azithromycin is not, however, a first-line agent for this condition. Amoxicillin or another beta lactam antibiotic is generally preferred
• Pharyngitis or tonsillitis caused by S. pyogenes as an alternative to first-line therapy in individuals who cannot use first-line therapy

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