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Clarithromycin

Clarithromycin is a macrolide antibiotic used to treat various bacterial infections such as respiratory tract infections, skin infections, and ulcers. It works by inhibiting bacterial protein synthesis. Common side effects include diarrhea, nausea, vomiting, and headache. It can interact with other drugs to increase their levels and effects. Patients should take it with food if gastrointestinal side effects occur and complete the full course of therapy.

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2K views3 pages

Clarithromycin

Clarithromycin is a macrolide antibiotic used to treat various bacterial infections such as respiratory tract infections, skin infections, and ulcers. It works by inhibiting bacterial protein synthesis. Common side effects include diarrhea, nausea, vomiting, and headache. It can interact with other drugs to increase their levels and effects. Patients should take it with food if gastrointestinal side effects occur and complete the full course of therapy.

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api-3797941
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© Attribution Non-Commercial (BY-NC)
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clarithromycin

(klar ith' ro my sin)


Biaxin, Biaxin XL

Pregnancy Category B

Drug class
Macrolide antibiotic

Therapeutic actions
Inhibits protein synthesis in susceptible bacteria, causing cell death.

Indications
• Treatment of upper respiratory infections caused by S. pyogenes, S. pneumoniae
• Treatment of lower respiratory infections caused by Mycoplasma pneumoniae, S.
pneumoniae, H. influenzae, M. catarrhalis
• Treatment of skin and skin-structure infections caused by S. aureus, S. pyogenes
• Treatment of disseminated mycobacterial infections due to M. avium and M.
intracellular
• Treatment of active duodenal ulcer with H. pylori in combination with proton
pump inhibitor
• Treatment of acute otitis media, acute maxillary sinusitis due to H. influenzae, M.
cararrhalis, S. pneumoniae
• ER tablets: Treatment of mild to moderate community-acquired pneumonia in
adults

Contraindications and cautions


• Contraindicated with hypersensitivity to clarithromycin, erythromycin, or any
macrolide antibiotic.
• Use cautiously with colitis, hepatic or renal impairment, pregnancy, lactation.

Available forms
Tablets—250, 500 mg; granules for suspension—125, 250 mg/5 mL; ER tablets–500 mg

Dosages
ADULTS
• Pharyngitis, tonsillitis; pneumonia due to S. pneumoniae, M. pneumoniae; skin or
skin-structure infections; lower respiratory infections due to S. pneumoniae, M.
catarrhalis: 250 mg PO q 12 hr for 7–14 days.
• Acute maxillary sinusitis, lower respiratory infection caused by H. influenzae:
500 mg PO q 12 hr for 7–14 days.
• Mycobacterial infections: 500 mg PO bid.
• Treatment of duodenal ulcers: 500 mg PO tid plus omeprazole 40 mg PO q AM
for 14 days, then omeprazole 20 mg PO q morning for 14 days.
• Treatment of community acquired pneunomia: 500 mg/day PO of ER tablet for 7
days.
PEDIATRIC PATIENTS
Usual dosage, 15 mg/kg/day PO q 12 hr for 10 days.
• Mycobacterial infections: 7.5 mg/kg PO bid.
GERIATRIC PATIENTS OR PATIENTS WITH IMPAIRED RENAL FUNCTION
Decrease dosage or prolong dosing intervals as appropriate.

Pharmacokinetics
Route Onset Peak
Oral Varies 2 hr

Metabolism: Hepatic; T1/2: 3–7 hr


Distribution: Crosses placenta; enters breast milk
Excretion: Urine

Adverse effects
• CNS: Dizziness, headache, vertigo, somnolence, fatigue
• GI: Diarrhea, abdominal pain, nausea, dyspepsia, flatulence, vomiting, melena,
pseudomembranous colitis
• Other: Superinfections, increased PT, decreased WBC

Interactions
Drug-drug
• Increased serum levels and effects of carbamazepine, theophylline, lovastatin,
phenytoin
Drug-food
• Food decreases the rate of absorption of clarithromycin but does not alter
effectiveness
• Decreased metabolism and risk of toxic effects if combined with grapefruit juice;
avoid this combination.

Nursing considerations
Assessment
• History: Hypersensitivity to clarithromycin, erythromycin, or any macrolide
antibiotic; pseudomembranous colitis, hepatic or renal impairment, lactation,
pregnancy
• Physical: Site of infection; skin color, lesions; orientation, GI output, bowel
sounds, liver evaluation; culture and sensitivity tests of infection, urinalysis, liver
and renal function tests

Interventions
• Culture infection before therapy.
• Do not cut or crush, and ensure that patient does not chew ER tablets.
• Monitor patient for anticipated response.
• Administer without regard to meals; administer with food if GI effects occur.
Teaching points
• Take drug with food if GI effects occur. Take the full course of therapy. Do not
drink grapefruit juice while taking this drug.
• Shake suspension before use; do not refrigerate; do not cut, crush, or chew ER
tablets; swallow whole.
• These side effects may occur: Stomach cramping, discomfort, diarrhea; fatigue,
headache (medication may be ordered); additional infections in the mouth or
vagina (consult with care provider for treatment).
• Report severe or watery diarrhea, severe nausea or vomiting, rash or itching,
mouth sores, vaginal sores.

Adverse effects in Italic are most common; those in Bold are life-threatening.

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