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