Antimicrobials
Clarithromycin

Clarithromycin

Medium
Moderate

Dosing

General Information

  • Pertussis
  • Nontuberculous mycobacteria (NTM) : prophylaxis (advanced HIV infection) and treatment (in combination with other agents)
  • Bartonella infections
  • Legionella infections
  • H. pylori (in combination)

Alternative:

  • Bacterial COPD exacerbation
  • Acute otitis media
  • Mild – moderate community acquired pneumonia
  • Pharyngitis

Monitor QTc in patients with increased risk

  • Prolongation of QTc interval
  • Cytopenias
  • GI upset
  • Drug interactions
  • Increased liver enzymes
  • Metallic taste

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

- CYP450 interactions ++

  • Other QTc prolonging agents
  • Statins - increased rhabdomyolysis
  • Calcium Channel Blockers - 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