clarithromycin


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clarithromycin

 [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.

clarithromycin

Biaxin Filmtab, Biaxin Granules, Biaxin XL Filmtab, Clarosip (UK), 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. 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 United States), cisapride, or pimozide.

• Don't refrigerate oral suspension.

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.

clarithromycin

(klə-rĭth′rə-mī′sĭn)
n.
A macrolide antibiotic, C38H69NO13, used to treat a variety of bacterial infections, especially of the respiratory tract.

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.

clarithromycin

A MACROLIDE antibiotic drug. A brand name is Klaricid.
References in periodicals archive ?
drug clarithromycin granules (powder) for the preparation of suspensions for internal use of 25 mg / ml in 5 ml 6,900 ml, 816.
[ClickPress, Mon Apr 29 2019] Clarithromycin belongs to class of macrolide antibiotics.
The prevalence of primary clarithromycin resistance exceeded 15% in the WHO European Region (18%; 95% confidence interval, 16%-20%), the Eastern Mediterranean Region (33%), and the Western Pacific Region (34%) and reached 10% in the Americas and the South East Asia region.
Group A received clarithromycin 500mg, amoxicillin 1g and omeprazole 20mg twice a day for two weeks.
Patients received twice-daily clarithromycin, amoxicillin and omeprazole during 10 days.
The CLARICOR trial followed 4,372 randomized patients for at least 2 years after undergoing 14 days of treatment with daily doses of 500 mg clarithromycin. Among these patients, researchers observed an unexpected increase in deaths in patients with coronary heart disease.
(3,6) However, given that topical antibiotics are more expensive than single-dose oral treatment and are no better than the oral formulations of these antibiotics, (6) clarithromycin 1 g taken once orally may be preferred.
pylori therapy using clarithromycin is bound to be defeated in the case of high clarithromycin resistance (>20%).
Objective: To conduct the bioequivalence study of commercially available two brands of clarithromycin tablets (500 mg) in healthy Pakistani male volunteers.
Several publications indicate that these mutations are responsible for causing resistance to clarithromycin, the first line drug prescribed for eradicating H.
The next day, the acid-fast (AF) staining was reported as positive and vancomycin was replaced by compounded clarithromycin 1% drops along with gatifloxacin 0.4% every hour in both eyes.
Currently, the international guidelines for treatment support a 7-to 14-day, triple-drug regimen consisting of a proton-pump inhibitor (PPI), clarithromycin, and either amoxicillin or an imidazole (1,2).