clarithromycin

clarithromycin /cla·rith·ro·my·cin/ (klah-rith″ro-mi´sin) a macrolide antibiotic effective against a wide spectrum of gram-positive and gram-negative bacteria; used in the treatment of respiratory tract, skin, and soft tissue infections and of Helicobacter pylori –associated duodenal ulcer.

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cla·rith·ro·my·cin (kl-rthr-msn)

n.

A macrolide antibiotic used primarily to treat bacterial respiratory infections.

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clarithromycin,

n brand name: Biaxin;
drug class: macrolide antibiotic;
action: binds to 50S ribosomal subunits of susceptible bacteria and suppresses protein synthesis;
uses: treatment of mild to moderate infections of the upper and lower respiratory tracts, otitis media, acute maxillary sinusitis.

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clarithromycin

a macrolide antibiotic derived from erythromycin, with similar properties.

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clarithromycin

Biaxin Filmtab, Biaxin Granules, Biaxin XL Filmtab, Klaricid (UK)

Pharmacologic class: Macrolide

Therapeutic class: Anti-infective, antiulcer drug

Pregnancy risk category B

Action

Reversibly binds to 50S ribosomal subunit of susceptible bacterial organisms, blocking protein synthesis

Availability

Granules for oral suspension: 125 mg/5 ml, 250 mg/5 ml

Tablets: 250 mg, 500 mg

Tablets (extended-release): 500 mg

⊘Indications and dosages

➣ Pharyngitis or tonsillitis caused by Streptococcus pyogenes

Adults: 250 mg P.O. q 12 hours for 10 days

➣ Acute maxillary sinusitis caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae

Adults: 500 mg P.O. q 12 hours for 14 days or two 500-mg extended-release tablets P.O. q 24 hours for 14 days

Children: 7.5 mg/kg P.O. q 12 hours for 10 days

➣ Acute exacerbation of chronic bronchitis caused by H. influenzae, Haemophilus parainfluenzae, M. catarrhalis, or S. pneumoniae

Adults: 500 mg P.O. q 12 hours for 7 to 14 days or two 500-mg extended-release tablets P.O. q 24 hours for 7 days

➣ Community-acquired pneumonia caused by S. pneumoniae, Mycoplasma pneumoniae, or Chlamydia pneumoniae; acute exacerbation of chronic bronchitis caused by S. pneumoniae or M. catarrhalis

Adults: 250 mg P.O. q 12 hours for 7 to 14 days or two 500-mg extended-release tablets P.O. q 24 hours for 7 days

Children: 7.5 mg/kg P.O. q 12 hours for 10 days

➣ Community-acquired pneumonia caused by H. influenzae

Adults: 250 mg P.O. q 12 hours for 7 days or two 500-mg extended-release tablets P.O. q 24 hours for 7 days

➣ Community-acquired pneumonia caused by H. parainfluenzae or M. catarrhalis

Adults: Two 500-mg extended-release tablets P.O. q 24 hours for 7 days

➣ Uncomplicated skin and skin-structure infections

Adults: 250 mg P.O. q 12 hours for 7 to 14 days

➣ Eradication of Helicobacter pylori as part of triple therapy with amoxicillin and omeprazole or lansoprazole

Adults: 500 mg P.O. q 12 hours for 10 to 14 days

➣ Eradication of H. pylori as part of dual therapy with omeprazole or ranitidine

Adults: 500 mg P.O. t.i.d. for 14 days

➣ Mycobacterial infections

Adults: 500 mg P.O. b.i.d.

Children: 7.5 mg/kg P.O. b.i.d., up to 500 mg b.i.d.

➣ Acute otitis media

Children: 7.5 mg/kg P.O. q 12 hours for 10 days

Dosage adjustment

• Renal or hepatic impairment

Off-label uses

• Borrelia burgdorferi infection

Contraindications

• Hypersensitivity to drug, erythromycin, or other macrolide anti-infectives
• Concurrent use of astemizole, cisapride, or pimozide
• Cardiac disease

Precautions

Use cautiously in:
• severe renal or hepatic impairment
• pregnant or breastfeeding patients.

Administration

• Obtain specimens for culture and sensitivity testing as appropriate before starting therapy.
• Give with or without food.
☞ Don't give concurrently with astemizole (no longer available in U.S.), cisapride, or pimozide.
• Don't refrigerate oral suspension.

Route	Onset	Peak	Duration
P.O.	Unknown	2 hr	12 hr
P.O. (extended)	Unknown	4 hr	24 hr

Adverse reactions

CNS: headache

CV: ventricular arrhythmias

GI: nausea, diarrhea, abdominal pain or discomfort, dyspepsia

Other: abnormal taste

Interactions

Drug-drug. Astemizole, cisapride, pimozide: increased risk of arrhythmias and sudden death

Carbamazepine, digoxin, theophylline: increased blood levels of these drugs, greater risk of toxicity

Digoxin: increased digoxin blood level, causing digoxin toxicity

HMG-CoA reductase inhibitors (such as lovastatin, simvastatin): rhabdomyolysis

Zidovudine: increased or decreased peak zidovudine blood level

Drug-diagnostic tests. Alkaline phosphatase, blood urea nitrogen: increased values

Prothrombin time: increased

White blood cells: decreased count

Patient monitoring

• Monitor hepatic enzyme and creatinine levels during long-term therapy.
• Assess cardiovascular status.

Patient teaching

• Advise patient to take drug with full glass of water, either with food or on an empty stomach.
• Tell patient using oral suspension not to refrigerate it, and to discard it 14 days after mixing.
• Tell patient to swallow extended-release tablets whole.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

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clarithromycin

Biaxin^® Infectious disease A broad-spectrum semi-synthetic macrolide antibiotic used for acute exacerbation of chronic bronchitis, acute maxillary sinusitis, acute otitis media by H influenzae, M catarrhalis, and S pneumoniae, community acquired pneumonia by S pneumoniae, Mycoplasma pneumoniae, C pneumoniae, as well as S aureus, M catarrhalis, MAC, combined with other agents or prophylactically with omeprazole, for H pylori Adverse effects Diarrhea, N&V, dyspepsia, abdominal pain, headache, dysgeusia. See Chronic bronchitis.