Pharyngitis, sinusitis, chronic bronchitis, pneumonia, skin & soft tissue infection,duodenal ulcers for eradication of H. pylori.
Clarithromycin acts by inhibiting microsomal protein synthesis in susceptible organisms mainly by binding to the donor site on the 50S subunit of the bacterial ribosome and preventing translocation to that site. Clarithromycin is active against most Gram-positive bacteria and Chlamydia, some Gram-negative bacteria and Mycoplasmas. Clarithromycin's activity is the same as, or greater than, that of Erythromycin in vitro against most Gram-positive bacteria. Clarithromycin is more acid-stable than Erythromycin and therefore, is better tolerated. Clarithromycin has twice the activity of Erythromycin against H. influenzae. Most species of Gram-negative bacteria are resistant to Clarithromycin because of failure to penetrate the target.
Adults : 250 - 500 mg for 7-14 days. Children: 7.5 mg/kg twice daily.
Drug interaction with medication: Clarithromycin is contraindicated when co-administration with HMG-CoA reductase inhibitors (e.g., lovastatin and simvastatin), gastroprokinetic agents (e.g., cisapride), ergot alkaloids (e.g., ergotamine and dihydroergotamine), antipsychotics (e.g., pimozide and quetiapine) and anti-gout agents (e.g., colchicine). Antiarrhythmics drugs (e.g., disopyramide, quinidine, dofetilide, amiodarone, sotalol and procainamide) are not recommended to use with clarithromycin.
Hypersensitivity, caution should be taken in administering this antibiotic to patients with impaired hepatic & renal function. Prolonged or repeated use of Clarithromycin may result in an overgrowth of non-susceptible bacteria or fungi.
GI upset, glossitis, stomatitis, altered taste; headache, dizziness, hallucinations, insomnia, other CNS effects; rash; hepatic dysfunction, Pseudomembranous colitis, anaphylaxis, Stevens-Johnson syndrome.
Clarithromycin is not recommended.
Reports indicate that the ingestion of large amounts of clarithromycin can be expected to produce gastro-intestinal symptoms. One patient who had a history of bipolar disorder ingested 8 grams of clarithromycin and showed altered mental status, paranoid behaviour, hypokalemia and hypoxemia. Adverse reactions accompanying overdosage should be treated by the prompt elimination of unabsorbed drug and supportive measures. As with other macrolides, clarithromycin serum levels are not expected to be appreciably affected by haemodialysis or peritoneal dialysis.
Store in a cool and dry place, protected from light & moisture. The reconstituted suspension must be used within 7 days if kept at room temperature and within 14 days when stored in a refrigerator. Keep out of reach of children.
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