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To prepare a liquid suspension form one dose packet mix one packet with 2 ounces of water, shake and drink at once. Do not use the suspension which was prepared longer than 12 hours ago. Tablets and suspension can be taken with or without food while capsules should be taken on an empty stomach 2 hours before or after a meal. Take the missed dose when you remember. If it is almost time of the next intake just skip it and return to your schedule. Zithromax is not recommended to take with aluminum- or magnesium- based antacids, such as Mylanta or Maalox as they decrease its absorption in the intestine. We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. 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Zithromax is a semi-synthetic macrolide antibiotic chemically related to erythromycin which is active against majority of species of gram positive and gram negative microorganisms such as genus Staphylococcus; S. aureus, S. pneumoiane, S. pyogenes, S. agalactiae, Haemophilus influenzae and parainfluenzae, Moraxela catarrhalis, Bacteroides fragilis, Escherichia coli, Bordetella ssp., Borrelia burgdorferi, Haemophilus ducreui, Nisseria gonorrhoeae O Chlamidia trachomati. In vitro it showed activity against Legionella pneumophila, Mycoplasma pneumoiae O hominis, Helicobacter pylori, Toxoplasma gondii, Ureaplasma urealiticum. As a Macrolide antibiotic Zithromax inhibits bacterial protein synthesis and prevents bacteria from growth and propagation. 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