To expand briefly, it is as follows: when I was a resident, I would give the azithromycin 500mg in the ED to those patients in which it was clinically indicated, and would write for 250mg PO qd x4d to go, and never thought much about it, although I did have my question if the prepackaged 6 pills cost the same as the 4 loose ones (which has now been answered). It came to light at my new job, where the people here are a step down in money (like, borderline destitute), but are too proud/unwilling/self-sufficient/"getting by"/not-entitled to apply for MedicAid (as my dad used to say, "they don't have a pot to **** in", but there's food on the table and the kids go to school wearing shoes, and that's enough, even though the raw dollars are LOW), so, when I see them, I'm trying to be the most efficient. What some of the docs do is give the 500mg in the ED, then also write for the Z-pak, so the patients get six days of treatment, with 500mg x2 days, then the 250. The perspective is that the extra 750mg and day are unlikely to add to morbidity. That's something that is new to me.
At the same time, I've already written several Rx's for high-dose amox in adults (and have yet to write for Augmentin since I've been here). So, please, don't look at me like I'm the enemy!!
And thanks to all for your input from across the nation - it's interesting to see consistency and difference when they exist.
