Clarithromycin

C difficile risk
Medium
Oral Bioavailability
Moderate

Dosing

500mg PO BID

eGFR 0 - 10eGFR 10 - 50eGFR > 50500mg PO daily500mg PO q12-24h500mg PO q12h

500mg PO daily

Dose after dialysis on HD days

General Information

  • CAP

  • Pertussis

  • URTI

  • H. pylorI and mycobacterial infections

Monitor QTc in patients with increased risk

  • 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

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

Antimicrobial class: Macrolide

Pregnancy category: C

Average serum half life: 5 hours

Urine penetration: Poor

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Therapeutic

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