Zithromax is easy to tolerate. It causes the least upset in bowel bacteria. If it has any downside it is the long time it remains in the body due to slow metabolism by the liver (10 days).
For normal healthy people, this is not a problem however.

The macrolide Biaxin (clarithromycin) however, has been implicated in damaging the nerves in the nose...some people have lost their sense of smell with this drug (sometimes permanently)..mostly in the older elderly patients. So we don't see common use of it for upper respiratory infections. It is reserved for ulcers.

On the whole there is much less allergy to the macrolides.
I don't think you'll have any PN issues, Monica.

Long term use, for staph infections, or Lyme, etc do deplete B-complex. But the normal short courses are not an issue IMO with it. You might want to eat yogurt while on it and after for while to protect the beneficial bowel bacteria.

I've used this drug many times with no nasty side effects ever.