Class: Macrolide Antibiotic
Dosage Forms. Tablet: 250 mg, 500 mg; Suspension: 125 mg/5 mL; 250 mg/5 mL; Extended-Release Tablet: 500 mg
Common FDA Label Indication, Dosing, and Titration.
1. Acute infective exacerbation of COPD: 250-500 mg po bid × 7-14 d
2. Community acquired pneumonia, skin infection, sinusitis, pharyngitis: Adults, 250 mg po bid × 7-14 d or extended-release tablets, 1000 mg po daily for 7 d; Children 6 mo and older, 15 mg/kg/d divided q12h × 10 d
3. Disseminated infection due to Mycobacterium avium-intracellulare group, prophylaxis-HIV infection, primary prevention and treatment: 500 mg po bid
4. Helicobacter pylori gastrointestinal tract infection: 500 mg, bid × 10-14 d in combination with various other antibiotics and PPIs
1. Bacterial endocarditis prophylaxis for high-risk patients; dental, respiratory, or infected skin/skin structure or musculoskeletal tissue procedures: Adults, 500 mg po 30-60 min prior to procedure; Children, 15 mg/kg po 30-60 min prior to procedure
MOA. Clarithromycin binds to the 50S ribosomal subunit of the 70S ribosome of susceptible organisms, thereby inhibiting bacterial RNA-dependent protein synthesis.
Drug Characteristics: Clarithromycin
Medication Safety Issues: Clarithromycin
Drug Interactions: Clarithromycin
Adverse Reactions: Clarithromycin
Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection.
Toxicity Monitoring Parameters. Seek medical attention if heart palpitations, blistering skin rash, unusual bruising or bleeding, yellowing of skin or eyes, or extreme fatigue.
Key Patient Counseling Points. Complete full course of therapy. Symptoms should improve within 2-3 d; if they worsen, seek follow-up with healthcare practitioner.
Clinical Pearls. Use with caution in severe renal, hepatic, or cardiac disease. Extended-release and immediate-release formulations are not interchangeable. Multiple drug interactions. Max dose in children, 1 g/d.