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Clarithromycin

Medical and Pharmacy Editor:

Brand Name: Biaxin, Biaxin XL

Generic Name: Clarithromycin

Drug Class: Macrolides

What Is Clarithromycin and How Does It Work?

Clarithromycin is a prescription drug used to treat a wide variety of bacterial infections. This medication can also be used in combination with anti-ulcer medications to treat certain types of stomach ulcers. It may also be used to prevent certain bacterial infections. Clarithromycin is known as a macrolide antibiotic. It works by stopping the growth of bacteria.

Clarithromycin is available under the following different brand names: Biaxin, and Biaxin XL.

Dosage of Clarithromycin:

Adult and pediatric dosages:

Oral suspension

  • 125 mg/5 ml
  • 250 mg/5 ml

Tablet

  • 250 mg
  • 500 mg

Tablet, extended release (adult dosage only, safety and efficacy not established in children)

  • 500 mg

Dosing Considerations – Should be Given as Follows:

Acute Exacerbation of Chronic Bronchitis

Adults:

  • 250-500 mg orally every 12 hours for 7-14 days
  • Extended release: 1,000 mg orally once daily for 7 days

Pediatric:

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

Acute Maxillary Sinusitis

Adult Dosage:

  • 500 mg orally every 12 hours for 14 days
  • Extended release: 1,000 mg orally once daily for 14 days

Pediatric Dosage:

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

Mycobacterial Infection

Adult Dosage:

  • 500 mg orally every 12 hours for 7-14 days
  • Use with antimycobacterial drugs such as rifampin and ethambutol

Pediatric Dosage:

Prophylaxis and treatment

  • 7.5 mg/kg orally divided every 12 hours; individual dose not to exceed 500 mg
  • Children under 20 months: safety of clarithromycin for mycobacterium avium complex not studied

Peptic Ulcer Disease

Adult Dosage:

  • 500 mg orally every 8-12 hours for 10-14 days
  • Administer as part of 2- or 3-drug combination regimen with bismuth subsalicylate, amoxicillin, H2 receptor antagonist, or proton pump inhibitor

Pharyngitis, Tonsillitis

  • 250 mg orally every 12 hours for 10 days

Streptococcal Pharyngitis

Pediatric Dosage:

  • 7 mg/kg orally every 12 hours for 10 days; individual dose not to exceed 500 mg

Community-Acquired Pneumonia

Adult Dosage:

  • 250 mg orally every 12 hours for 7-14 days
  • Extended release: 1,000 mg orally once daily for 7 days

Pediatric Dosage:

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

Pertussis (off-label)

Adult dosage:

  • 500 mg orally twice daily for 7 days

Pediatric Dosage:

  • Infants under 1 month: safety and efficacy not established
  • Infants 1-6 months: 7.5 mg/kg/dose orally every 12 hours for 7 days
  • Infants over 6 months: 7.5 mg/kg/dose orally every 12 hours for 7 days

Skin/Skin Suture Infection

Adult Dosage:

  • 250 mg orally for every 12 hours for 7-14 days

Pediatric Dosage:

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

Endocarditis

Adult Dosage:

Prophylaxis

  • 500 mg orally 30-60 minutes before surgical procedure

Pediatric Dosage:

Prophylaxis

  • 15 mg/kg orally 30-60 minutes before surgical procedure; individual dose not to exceed 500 mg

Dosing Modifications

  • Renal impairment (creatinine clearance under 30 ml/min): reduce normal dosage by 50%
  • In combination with atazanavir: creatinine clearance 30-60 ml/min decrease dose by 50%; creatinine clearance under 30 ml/min, decrease dose by 75%

Dosing Considerations

Susceptible organisms:

  • Actinobacillus actinomycetemcomitans, Actinomyces israelii, Actinomyces naeslundii, Actinomyces odontolyticus, Afipia felis, Arachnia propionica, Bartonella henselae, Bartonella quintana, Chlamydia pneumoniae (TWAR agent), Bordetella pertussis, Borrelia recurrentis, Calymmatobacterium granulomatis, Campylobacter jejuni, Chlamydia spp, Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Legionella pneumophila, Mycobacterium avium complex (MAC), Mycobacterium chelonae, Mycobacterium fortuitum, Mycobacterium genavense, Mycobacterium gordonae, Mycobacterium kansasii, Mycobacterium leprae, Mycobacterium marinum, Mycobacterium scrofulaceum, Mycobacterium simiae, Mycobacterium szulgai, Mycobacterium ulcerans, Mycobacterium xenopi, Mycoplasma pneumoniae, Moraxella (Branhamella) catarrhalis, Staphylococcus aureus, Streptococcus (group C, G), Streptococcus agalactiae (group B), Streptococcus bovis (group D), Streptococcus intermedius group (Streptococcus anginosus, Streptococcus intermedius, Streptococcus constellatus), Streptococcus pneumoniae (penicillin sensitive; minimal inhibitory concentration [MIC] under 0.1 mcg/mL), Streptococcus pyogenes (group A), viridans streptococci, Ureaplasma urealyticum
  • H. pylori (with lansoprazole and amoxicillin)
  • First-line: A felis, B henselae, B quintana, B pertussis, C jejuni, C pneumoniae, H ducreyi, H pylori, Legionella spp, Mycobacterium avium complex (MAC), M chelonae, M fortuitum, M genavense, M gordonae, M marinum, M scrofulaceum, M simiae, M xenopi; no unanimity on others (H influenzae)
Medically Reviewed by a Doctor on 6/7/2017



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