AZM is dibasic compared to the monobasic 14-member ring structure macrolides.
The pKa value of AZM describing the two nitrogen groups undergoing dissociation is 8.85 (8.8 and 8.9) and almost equal to the pKa 8.6–8.9 of erythromycin (Goldman et al.,1990).
At physiological pH, both antimicrobial agents are protonated and <4% will be in their neutral, non-ionised form.
Macrolides tend to accumulate in tissues due to higher level of ionisation compared to serum (pH gradient).
Skin tissue pH increases as a result of an infection
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