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Azithromycin Shortage and STD Treatment Guidelines

Posted By Administration, Friday, April 24, 2020

Society PA,

The Food and Drug Administration (FDA) has reported a national shortage of azithromycin. Although supply is available from select wholesalers at this time, ADHS recommends judicious prescribing to maintain adequate supply:

  • Only prescribe azithromycin for conditions that need to be treated with azithromycin. Consider alternative treatment regimens as clinically indicated.
  • Notify ADHS at  and the FDA at if you experience difficulty procuring azithromycin or other drugs that impact treatment of STIs.
  • If you have a patient in need of treatment for an STI but do not have the recommended therapy available, contact your local health department to arrange for treatment.
  • If you have less than a three week supply of azithromycin and cannot procure more, consider using an alternative therapy for the following STIs described below and reserve azithromycin for women who are pregnant.
  • Doxycycline is not a suitable alternative therapy for pregnant women.




Alternative Therapy


Uncomplicated genital/rectal/ pharyngeal


OR doxycycline

1 g orally in a single dose

100 mg orally 2x/day for 7 days

Erythromycin base 500 mg orally 4x/day for 7 days

OR erythromycin ethylsuccinate 800 mg orally 4x/day for 7 days


Uncomplicated genital/rectal

Dual therapy with ceftriaxone

PLUS azithromycin

250 mg IM in a single dose

1 g dose orally

Dual therapy with cefixime 400 mg orally PLUS azithromycin 1 g orally

OR Dual therapy with cefixime 400 mg orally PLUS doxycycline 100 mg orally 2x/day for 7 days

*Additional alternative therapies can be found in the full 2015 STD treatment guidelines and the 2015 STD Treatment Summary chart

Please refer to the FDA website for the latest updates on drug supply availability.

For more information:

Thank you,
Arizona Health Alert Network

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