항생제
Clarithromycin

Clarithromycin

Medium
Moderate

Spectrum Of Activity

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.