Clarithromycin: Difference between revisions
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==Adult Dosing==
==Adult Dosing==
*infections, bacterial
**250-500mg PO q12h x 7-14d
**Alt: 1000mg ER PO qd x 7-14d
*chronic bronchitis, actue bacterial exacerbation
**1000 mg ER PO q24 x 7d (with food, do not cut/crush/chew)
**Alt: 250-500mg PO q12h x 7-14d
*pharyngitis/tonsillitis, streptococcal
**250mg PO q12h x 10d
*MAC primary prophylaxis
**500mg PO q12h
*MAC secondary prophylaxis, HIV ptx
**500mg q12h (use with ethambutol)
*MAC tx, disseminated
**500mg PO q12h (use with ethambutol)
*H. pylori infection
**triple tx: 500mg PO q12hr x 7-14d
**dual tx: 500mg PO q8h x 14d (give with Omeprazole 40mg qd x 14d)
*endocarditis prophylaxis, dental
**500mg PO x1 (30-60min before procedure)


==Pediatric Dosing==
==Pediatric Dosing==

Revision as of 01:12, 3 September 2015

General

  • Type: macrolide
  • Dosage Forms: 250, 500, 500ER; 125, 250/5ml
  • Common Trade Names: Biaxin, Biaxin XL

Adult Dosing

  • infections, bacterial
    • 250-500mg PO q12h x 7-14d
    • Alt: 1000mg ER PO qd x 7-14d
  • chronic bronchitis, actue bacterial exacerbation
    • 1000 mg ER PO q24 x 7d (with food, do not cut/crush/chew)
    • Alt: 250-500mg PO q12h x 7-14d
  • pharyngitis/tonsillitis, streptococcal
    • 250mg PO q12h x 10d
  • MAC primary prophylaxis
    • 500mg PO q12h
  • MAC secondary prophylaxis, HIV ptx
    • 500mg q12h (use with ethambutol)
  • MAC tx, disseminated
    • 500mg PO q12h (use with ethambutol)
  • H. pylori infection
    • triple tx: 500mg PO q12hr x 7-14d
    • dual tx: 500mg PO q8h x 14d (give with Omeprazole 40mg qd x 14d)
  • endocarditis prophylaxis, dental
    • 500mg PO x1 (30-60min before procedure)

Pediatric Dosing

Special Populations

  • Pregnancy:
  • Lactation:
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug
  • Liver disease
  • Renal disease

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 3-4 hours (increased with dosage increase)[1]
  • Metabolism: hepatic (rapid first-pass metabolism)
  • Excretion: renal
  • Mechanism of Action: interferes with bacterial protein synthesis by binding to a component of the 50S subunit

Antibiotic Sensitivities[2]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G I
Strep. Pneumoniae I
Viridans strep X1
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium R
MSSA S
MRSA R
CA-MRSA I
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae I
N. meningitidis X1
Moraxella catarrhalis S
H. influenzae S
E. coli R
Klebsiella sp R
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp X1
Serratia marcescens R
Salmonella sp R
Shigella sp R
Proteus mirabilis X1
Proteus vulgaris R
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica R
Francisella tularensis X1
Brucella sp. R
Legionella sp. S
Pasteurella multocida X1
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp S
Mycoplasm pneumoniae S
Rickettsia sp X1
Mycobacterium avium S
Anaerobes Actinomyces S
Bacteroides fragilis R
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum R
Peptostreptococcus sp. I

Key

Template:Antibacterial Spectra Key

See Also

Source

  1. ↑ Ferrero JL, Bopp BA, Marsh KC, et al. Metabolism and Disposition of Clarithromycin in Man. Drug Metab Dispos. 1990;18(4):441–446. [PubMed 1976065]
  2. ↑ Sanford Guide to Antimicrobial Therapy 2014
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