Spectrum of Activity


General Information

PO only

  • Administer extended release tablets with food, do not break/crush/chew
  • IR tablet/suspensions with or without meals
  • CAP
  • Pertussis
  • URTI
  • H. pylorI and mycobacterial infections

Tier One

  • Narrow spectrum, possible transition for discharge, IV to PO
  • Strategy: total EBM duration set (inpatient and outpatient)

Monitor QTc in patients with increased risk

BUN and SCr for renal function/injury

Monitor for extensive diarrhea or bloody diarrhea, test for C. diff. as indicated

  • Neutropenia
  • GI upset
  • Prolongation of QTc interval
  • Drug interactions

Recommend review of patient medications due to high frequency of significant interactions

  • CYP450 interactions ++
  • Other QTc prolonging agents
  • Statins - increased rhabdo
  • CCBs - hypotension, AKI
  • Colchicine - increased bone marrow toxicity
  • Increased anticonvulsant levels
  • Increased tacrolimus levels

Antimicrobial class: Macrolide

Pregnancy category: C

Average serum half life: 5 hours

Urine penetration: Poor

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Therapeutic

Very high tissue penetration and concentration intracellularly means in vivo activity may not be predicted by in vitro testing