Clarithromycin (Biaxin)

Category:

  • Antibiotic  

Description:

  • Macrolide

Indications:

  • Pharyngitis/Tonsillitis (S. pyogenes)

  • Acute maxilliary sinusitis (H. influenzae, M. catarrhalis, S. pneumoniae)

  • Acute bacterial exacerbation of chronic bronchitis (H. influenzae, M. catarrhalis, S. pneumoniae)

  • Pneumonia (Chlamydia pneumoniae, Strep. pneumoniae, Mycoplasma pneumoniae)

  • Skin infections (S. aureus, S. pyogenes)

  • Disseminated mycobacterial infections (Mycoplasma avium and intracellulare)

  • Mycobacterium Avium Complex prophylaxis

  • Helicobacter pylori therapy (double and triple)

  • Acute otitis media (H. influenzae, M. catarrhalis, S. pneumoniae)

Contraindications:

  • None

Precautions:

  • Pregnancy category B

  • Use alternate form of birth control (disrupts absorption of oral contraceptives and renders them inactive)

  • Counsel patient to finish all medication to prevent development of resistance

  • Do not use with aluminum or magnesium-containing antacids

  • Do not use with cisapride (ventricular arrythmias w/macrolides)

Adverse Reactions (Side Effects):

  • Hypersensitivity

  • Gastrointestinal: nausea, vomiting, diarrhea

  • Vaginitis  

Dosage:

  • Administered orally (tablets, granules for oral suspension)

  • Adult:

    • 250-500mg twice a day for 7-14 days

  • Pharyngitis/Tonsillitis: 

    • 250mg bid for 10 days

  • Maxilliary sinusitis: 

    • 500mg bid for 14 days

  • Chronic bronchitis & pneumonia (S. pneumoniae/M. catarrhalis): 

    • 250mg bid for 7-14 days

  • Chronic bronchitis (H. influenzae): 

    • 500mg bid for 7-14 days

  • Uncomplicated skin infections: 

    • 250mg bid for 7-14 days

  • MAC: 

    • 500mg bid

  • H. pylori treatment:

    • double tx: 500mg tid plus omeprazole 40mg qam days 1-14, then omeprazole 20mg qam days 15-28

    • triple tx: 500mg tid plus ranitidine bismuth citrate 400mg bid days 1-14, then ranitidine bismuth citrate 400mg bid days 15-28

  • Child:

    • 15mg/kg/day divided every 12 hours for 10 days

    • For oral suspension:  empty stomach, refrigerate, shake well, good for 14 days only

    • MAC: 7.5mg/kg/day up to 500mg twice a day

 
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