Azithromycin IV is recommended as the preferred IV azalide/macrolide, and is recommended for automatic substitution for erythromycin IV except for the following: patients less than 16 years old, pregnancy, and L&D uses.

Sensitivity of streptococcus pneumoniae is similar for macrolides and azalides (azithromycin, clarithromycin, and erythromycin) for penicillin sensitive, intermediate, and resistant strains with 90%, 70%, and 30% being sensitive, respectively.  Cross-resistance occurs to the class.