SickKids logo
Antimicrobials
Clarithromycin

Clarithromycin

Medium
Moderate
PO:$

General Information

  • Sickle cell disease: Ceftriaxone ± Erythromycin (IV) or Clarithromycin (PO)*
    • *Add erythromycin or clarithromycin if required for coverage against Chlamydophila pneumoniae, Mycoplasma pneumoniae
  • Pertussis: Alternative oral therapy
  • H. pylori infection: Alternative therapy (Amoxicillin + Metronidazole + Clarithromycin + PPI)
  • Sinusitis (acute & subacute): Alternative therapy

ODB Funded (tablets, ER tablets, oral liquid)

1% to 10%:

  • Central nervous system: Headache (2%), insomnia
  • Dermatologic: Skin rash (children 3%)
  • Gastrointestinal: Dysgeusia (adults 3% to 7%), vomiting (children 6%), diarrhea (3% to 6%), nausea (adults 3%), abdominal pain (2% to 3%), dyspepsia (adults 2%)
  • Hematologic & oncologic: Prolonged prothrombin time (adults 1%)
  • Hepatic: Abnormal hepatic function tests
  • Hypersensitivity: Anaphylactoid reaction
  • Infection: Candidiasis (including oral)
  • Renal: Increased blood urea nitrogen (4%)
  • CBC with differential, serum BUN and creatinine, liver function tests
  • Serum concentration of drugs whose concentrations may be affected in patients receiving concomitant clarithromycin (ie, theophylline, carbamazepine, quinidine, digoxin, anticoagulants, triazolam)
  • Hearing (in patients receiving long-term treatment with clarithromycin)
  • Observe for changes in bowel frequency
  • Immediate release: Food delays rate, but not extent of absorption
  • Extended release: Food increases clarithromycin AUC by ~30% relative to fasting conditions

Administer immediate release products without regard to meals. Administer extended release products with food.

  • May decrease clearance of tacrolimus, sirolimus, cyclosporine, other drugs
  • Consult pharmacy for details
  • Check for drug interactions prior to use
  • Clarithromycin is the preferred macrolide for admitted inpatients due to lower risk of inducing antibiotic resistance
  • Azithromycin may be considered in the case of drug interactions with clarithromycin or for neonates