Clarithromycin

제한된
0
C. difficile 위험도
Medium
경구생체이용률
Moderate

Dosing

Pharyngitis tonsillitisAcute maxillary sinusitisAECBCAPUncomplicated SSTIH. pylori eradicationM. avium complex infection250 mg PO q12h x10d500 mg PO q12h x14d250-500 mg PO q12h x7-14d250 mg PO q12h x7-14d250 mg PO q12h x7-14d500 mg PO q12h500 mg PO q12h

Usual doseSafety and efficacy in pediatric patients <6y of age have not been established7.5 mg/kg PO q12h x10d

No dose adjustment

CrCl ≥30CrCl <30No dose adjustment50% recommended dose PO q12h

General Information

  • CAP

  • Pertussis

  • URTI

  • H. pylori and mycobacterial infections

Monitor QTc in patients with increased risk.

Monitor fever, CBC, symptomatic improvement, hepatic and renal functions.

Common

  • Abdominal pain

  • Diarrhea

  • Disorder of taste

  • Indigestion

  • Nausea

  • Vomiting

  • Headache

Serious

  • Prolonged QTc interval

  • Stevens-Johnson syndrome

  • Toxic epidermal necrolysis

  • Henoch-Schönlein purpura

  • Clostridium difficile diarrhea

  • Hepatitis

  • Liver failure

  • Anaphylaxis

  • Drug reaction with eosinophilia

  • Cerebrovascular disease

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

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor

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

Precautions:

  • Avoid use in patients with ongoing proarrhythmic conditions or Class IA or III antiarrhythmics.

  • Discontinue if hepatotoxicity, acute hypersensitivity reaction or Clostridium difficile associated diarrhea is suspected.

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