Clarithromycin

Clarithromycin is a macrolide antibiotic used to treat a wide variety of bacterial infections. It is effective against both gram-positive and gram-negative bacteria. Clarithromycin is commonly used to treat infections of the respiratory tract, skin, and soft tissues. It is also used to prevent and treat infections in people with weakened immune systems.

Mechanism of Action

Clarithromycin exerts its antibacterial effects by binding to the 50S ribosomal subunit of susceptible bacteria, thereby inhibiting protein synthesis. It is bacteriostatic against most organisms, but may be bactericidal against some strains of Streptococcus pneumoniae and Haemophilus influenzae. Clarithromycin has a broad spectrum of activity against both gram-positive and gram-negative bacteria. It is particularly active against aerobic and facultative anaerobic gram-positive bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes. Clarithromycin is also active against some gram-negative bacteria, including Haemophilus influenzae, Moraxella catarrhalis, and Neisseria gonorrhoeae. Clarithromycin is well absorbed after oral administration, with peak serum concentrations occurring within 2 to 4 hours. It is widely distributed throughout the body, with high concentrations in the lungs, tonsils, and middle ear fluid. Clarithromycin is metabolized in the liver and excreted primarily in the urine and feces. Clarithromycin is generally well-tolerated, with the most common adverse effects being gastrointestinal disturbances such as nausea, vomiting, diarrhea, and abdominal pain. Clarithromycin can also cause headache, dizziness, and rash. In rare cases, it can cause serious adverse effects such as liver damage, kidney failure, and Stevens-Johnson syndrome. Clarithromycin should not be used by people who are allergic to it or to other macrolide antibiotics. It should also be used with caution in people with liver or kidney disease. Clarithromycin can interact with a number of other medications, so it is important to tell your doctor about all of the medications you are taking.

Indications

Clarithromycin is indicated for the treatment of mild to moderate infections caused by susceptible bacteria. These infections include⁚

• Upper respiratory tract infections, such as pharyngitis, tonsillitis, and sinusitis
• Lower respiratory tract infections, such as bronchitis and pneumonia
• Skin and skin structure infections, such as cellulitis and impetigo

Clarithromycin may also be used to prevent infections in people with weakened immune systems, such as those with HIV/AIDS or those undergoing chemotherapy.

Bacterial Infections

Clarithromycin is a macrolide antibiotic that is effective against a wide range of bacteria. It is commonly used to treat bacterial infections of the respiratory tract, skin, and soft tissues. Clarithromycin is also used to prevent and treat infections in people with weakened immune systems.

Strep Throat

Strep throat is a bacterial infection of the throat and tonsils caused by the bacteria Streptococcus pyogenes. Symptoms of strep throat include sore throat, fever, headache, and difficulty swallowing. Clarithromycin is a commonly used antibiotic for the treatment of strep throat.

Sinusitis

Sinusitis is an inflammation of the sinuses, which are air-filled cavities in the skull. Sinusitis can be caused by bacteria, viruses, or allergies. Symptoms of sinusitis include facial pain and pressure, nasal congestion, and headache. Clarithromycin is a commonly used antibiotic for the treatment of sinusitis.

Tonsillitis

Tonsillitis is an inflammation of the tonsils, which are two small glands at the back of the throat. Tonsillitis can be caused by bacteria or viruses. Symptoms of tonsillitis include sore throat, fever, headache, and difficulty swallowing. Clarithromycin is a commonly used antibiotic for the treatment of tonsillitis.

Ear Infections

Ear infections are infections of the middle ear, which is the air-filled space behind the eardrum. Ear infections can be caused by bacteria or viruses. Symptoms of an ear infection include ear pain, fever, and hearing loss. Clarithromycin is a commonly used antibiotic for the treatment of ear infections.

Lung Infections

Lung infections, such as bronchitis and pneumonia, can be caused by bacteria or viruses. Symptoms of a lung infection include cough, fever, shortness of breath, and chest pain; Clarithromycin is a commonly used antibiotic for the treatment of lung infections.

Skin Infections

Skin infections, such as cellulitis and impetigo, can be caused by bacteria or fungi. Symptoms of a skin infection include redness, swelling, pain, and drainage. Clarithromycin is a commonly used antibiotic for the treatment of skin infections.

Strep Throat

Strep throat is a bacterial infection of the throat and tonsils caused by the bacteria Streptococcus pyogenes. Symptoms of strep throat include sore throat, fever, headache, and difficulty swallowing. Clarithromycin is a commonly used antibiotic for the treatment of strep throat. It is effective against Streptococcus pyogenes and other bacteria that can cause strep throat. Clarithromycin is typically taken orally, twice a day for 10 days. It is important to take the full course of antibiotics, even if you start to feel better after a few days. This will help to ensure that the infection is completely cleared and to prevent the development of antibiotic resistance. If you have strep throat, it is important to see a doctor to get a prescription for antibiotics. Strep throat can lead to serious complications, such as rheumatic fever and kidney inflammation, if it is not treated properly. In addition to antibiotics, there are a number of other things you can do to relieve the symptoms of strep throat, such as⁚

• Gargling with warm salt water
• Drinking plenty of fluids
• Eating soft, cold foods
• Getting plenty of rest

If your symptoms do not improve after a few days, or if you have any difficulty breathing or swallowing, it is important to see a doctor right away.

Sinusitis

Sinusitis is an inflammation of the sinuses, which are air-filled cavities in the skull. Sinusitis can be caused by bacteria, viruses, or allergies. Symptoms of sinusitis include facial pain and pressure, nasal congestion, and headache. Clarithromycin is a commonly used antibiotic for the treatment of sinusitis. It is effective against a wide range of bacteria that can cause sinusitis, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Clarithromycin is typically taken orally, twice a day for 10-14 days. It is important to take the full course of antibiotics, even if you start to feel better after a few days. This will help to ensure that the infection is completely cleared and to prevent the development of antibiotic resistance. In addition to antibiotics, there are a number of other things you can do to relieve the symptoms of sinusitis, such as⁚

• Using a nasal decongestant spray or drops
• Applying a warm compress to your face
• Inhaling steam from a humidifier or hot shower
• Drinking plenty of fluids

If your symptoms do not improve after a few days, or if you have any difficulty breathing or swallowing, it is important to see a doctor right away.

Tonsillitis

Tonsillitis is an inflammation of the tonsils, which are two small glands at the back of the throat. Tonsillitis can be caused by bacteria or viruses. Symptoms of tonsillitis include sore throat, fever, headache, and difficulty swallowing. Clarithromycin is a commonly used antibiotic for the treatment of tonsillitis. It is effective against a wide range of bacteria that can cause tonsillitis, including Streptococcus pyogenes, Haemophilus influenzae, and Moraxella catarrhalis. Clarithromycin is typically taken orally, twice a day for 10 days. It is important to take the full course of antibiotics, even if you start to feel better after a few days. This will help to ensure that the infection is completely cleared and to prevent the development of antibiotic resistance. In addition to antibiotics, there are a number of other things you can do to relieve the symptoms of tonsillitis, such as⁚

• Gargling with warm salt water
• Drinking plenty of fluids
• Eating soft, cold foods
• Getting plenty of rest

If your symptoms do not improve after a few days, or if you have any difficulty breathing or swallowing, it is important to see a doctor right away.

Ear Infections

Ear infections are infections of the middle ear, which is the air-filled space behind the eardrum. Ear infections can be caused by bacteria or viruses. Symptoms of an ear infection include ear pain, fever, and hearing loss. Clarithromycin is a commonly used antibiotic for the treatment of ear infections. It is effective against a wide range of bacteria that can cause ear infections, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Clarithromycin is typically taken orally, twice a day for 10 days. It is important to take the full course of antibiotics, even if you start to feel better after a few days. This will help to ensure that the infection is completely cleared and to prevent the development of antibiotic resistance. In addition to antibiotics, there are a number of other things you can do to relieve the symptoms of an ear infection, such as⁚

• Applying a warm compress to your ear
• Taking over-the-counter pain relievers, such as ibuprofen or acetaminophen
• Getting plenty of rest

If your symptoms do not improve after a few days, or if you have any difficulty hearing or swallowing, it is important to see a doctor right away.

Lung Infections

Lung infections, such as bronchitis and pneumonia, can be caused by bacteria or viruses. Symptoms of a lung infection include cough, fever, shortness of breath, and chest pain. Clarithromycin is a commonly used antibiotic for the treatment of lung infections. It is effective against a wide range of bacteria that can cause lung infections, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Clarithromycin is typically taken orally, twice a day for 10-14 days. It is important to take the full course of antibiotics, even if you start to feel better after a few days. This will help to ensure that the infection is completely cleared and to prevent the development of antibiotic resistance. In addition to antibiotics, there are a number of other things you can do to relieve the symptoms of a lung infection, such as⁚

• Drinking plenty of fluids
• Getting plenty of rest
• Using a humidifier or taking a hot shower to help loosen mucus

If your symptoms do not improve after a few days, or if you have any difficulty breathing or swallowing, it is important to see a doctor right away.

Skin Infections

Skin infections, such as cellulitis and impetigo, can be caused by bacteria or fungi. Symptoms of a skin infection include redness, swelling, pain, and drainage. Clarithromycin is a commonly used antibiotic for the treatment of skin infections. It is effective against a wide range of bacteria that can cause skin infections, including Staphylococcus aureus and Streptococcus pyogenes. Clarithromycin is typically taken orally, twice a day for 10-14 days. It is important to take the full course of antibiotics, even if you start to feel better after a few days. This will help to ensure that the infection is completely cleared and to prevent the development of antibiotic resistance. In addition to antibiotics, there are a number of other things you can do to relieve the symptoms of a skin infection, such as⁚

• Cleaning the wound gently with soap and water
• Applying a warm compress to the wound
• Keeping the wound dry and bandaged

If your symptoms do not improve after a few days, or if you have any signs of infection, such as fever or chills, it is important to see a doctor right away.

Dosage and Administration

Clarithromycin is typically taken orally, twice a day with food. The usual dose for adults is 500 mg every 12 hours. The dose may be increased to 1,000 mg every 12 hours for more severe infections. Clarithromycin is also available as a suspension for oral administration. The usual dose for children is 7.5 mg/kg of body weight every 12 hours. The dose may be increased to 15 mg/kg of body weight every 12 hours for more severe infections. The duration of treatment with clarithromycin typically ranges from 7 to 14 days.

Oral Administration

Clarithromycin is typically taken orally, twice a day with food. The usual dose for adults is 500 mg every 12 hours. The dose may be increased to 1,000 mg every 12 hours for more severe infections. Clarithromycin is also available as a suspension for oral administration. The usual dose for children is 7.5 mg/kg of body weight every 12 hours. The dose may be increased to 15 mg/kg of body weight every 12 hours for more severe infections. Clarithromycin should be taken with food to improve absorption. It is important to take the full course of antibiotics, even if you start to feel better after a few days. This will help to ensure that the infection is completely cleared and to prevent the development of antibiotic resistance. If you have any difficulty swallowing the tablets, you can crush them and mix them with a small amount of water or food. Do not crush the extended-release tablets. Clarithromycin may interact with a number of other medications, so it is important to tell your doctor about all of the medications you are taking.

Dosage Forms

Clarithromycin is available in the following dosage forms⁚

• Tablets⁚ 250 mg, 500 mg, and 1,000 mg
• Extended-release tablets⁚ 500 mg and 1,000 mg
• Granules for oral suspension⁚ 125 mg/5 mL, 250 mg/5 mL, and 500 mg/5 mL
• Injection⁚ 500 mg/vial

The tablets and extended-release tablets are taken orally, twice a day with food. The granules for oral suspension are mixed with water and taken orally, twice a day with food. The injection is given intravenously (IV) over a period of 30 minutes, twice a day. The dose of clarithromycin will vary depending on the type of infection being treated, the severity of the infection, and the patient's age and weight. It is important to take clarithromycin exactly as prescribed by your doctor. Do not take more or less of the medication than prescribed, and do not take it for longer than prescribed.

Cost and Price

The cost of clarithromycin will vary depending on the dosage form, the quantity, and the pharmacy where it is purchased. The following are some average prices for clarithromycin⁚

• Tablets⁚ $10-$20 for a 10-day supply of 250 mg tablets
• Extended-release tablets⁚ $15-$25 for a 10-day supply of 500 mg tablets
• Granules for oral suspension⁚ $20-$30 for a 10-day supply of 125 mg/5 mL suspension
• Injection⁚ $50-$100 per vial

Clarithromycin is also available as a generic medication. Generic medications are typically less expensive than brand-name medications. If you are uninsured or underinsured, you may be able to get help paying for your prescription medications. There are a number of patient assistance programs available that can help you save money on your medications. You can also save money on your prescription medications by using a discount card. Discount cards are available from a number of different sources, including pharmacies, insurance companies, and patient assistance programs.

Side Effects

Clarithromycin is generally well-tolerated, but it can cause some side effects. The most common side effects include⁚

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Headache

Clarithromycin can also cause some more serious side effects, such as⁚

• Liver damage
• Kidney damage
• Stevens-Johnson syndrome

If you experience any of these side effects, it is important to stop taking clarithromycin and contact your doctor right away.

Common Side Effects

The most common side effects of clarithromycin include⁚

• Nausea⁚ Nausea is a feeling of queasiness and an urge to vomit. It is one of the most common side effects of clarithromycin, occurring in up to 10% of patients.
• Vomiting⁚ Vomiting is the forceful expulsion of stomach contents through the mouth. It is a less common side effect of clarithromycin, occurring in up to 5% of patients.
• Diarrhea⁚ Diarrhea is loose, watery stools. It is a common side effect of clarithromycin, occurring in up to 10% of patients.
• Abdominal pain⁚ Abdominal pain is pain in the abdomen. It is a common side effect of clarithromycin, occurring in up to 10% of patients.
• Headache⁚ Headache is pain in the head. It is a common side effect of clarithromycin, occurring in up to 10% of patients.

These side effects are usually mild and go away within a few days. However, if you experience any of these side effects, it is important to tell your doctor. In rare cases, clarithromycin can cause more serious side effects, such as liver damage, kidney damage, and Stevens-Johnson syndrome. These side effects are more likely to occur in people who take clarithromycin for a long period of time or who have other medical conditions. If you experience any of these serious side effects, it is important to stop taking clarithromycin and contact your doctor right away.

Headache

Headache is a common side effect of clarithromycin, occurring in up to 10% of patients. It is usually a mild to moderate headache that goes away within a few days. However, if you experience a severe headache or a headache that does not go away, it is important to tell your doctor. There are a number of things you can do to relieve a headache, such as⁚

• Rest in a quiet, dark room.
• Apply a cold compress to your forehead.
• Take over-the-counter pain relievers, such as ibuprofen or acetaminophen.

If your headache is severe or does not go away, it is important to see a doctor. In rare cases, clarithromycin can cause a serious side effect called intracranial hypertension. This is a condition in which the pressure inside the skull increases. Symptoms of intracranial hypertension include⁚

• Severe headache
• Nausea and vomiting
• Blurred vision
• Double vision
• Seizures

If you experience any of these symptoms, it is important to stop taking clarithromycin and contact your doctor right away.

Contraindications

Clarithromycin is contraindicated in the following situations⁚

• Hypersensitivity⁚ Clarithromycin is contraindicated in people who are allergic to clarithromycin or any other macrolide antibiotics.
• Concurrent use of certain medications⁚ Clarithromycin should not be taken with certain medications, including⁚
• Ergotamine
• Dihydroergotamine
• Pimozide
• Cisapride
• Terfenadine
• Astemizole
• Quinidine
• Disopyramide
• Amiodarone
• Sotalol
• History of QT prolongation⁚ Clarithromycin should not be taken by people who have a history of QT prolongation, a condition in which the electrical activity of the heart is abnormally slow.
• Severe liver disease⁚ Clarithromycin should not be taken by people with severe liver disease.

It is important to tell your doctor about all of the medications you are taking, including prescription and over-the-counter medications, vitamins, and herbal supplements. This will help your doctor determine if clarithromycin is right for you.

Precautions

Clarithromycin should be used with caution in the following situations⁚

• Mild to moderate liver disease⁚ Clarithromycin should be used with caution in people with mild to moderate liver disease. Your doctor may need to monitor your liver function while you are taking clarithromycin.
• Kidney disease⁚ Clarithromycin should be used with caution in people with kidney disease. Your doctor may need to adjust your dose of clarithromycin.
• Myasthenia gravis⁚ Clarithromycin may worsen the symptoms of myasthenia gravis, a condition in which the muscles become weak.
• Pregnancy⁚ Clarithromycin should only be used during pregnancy if the potential benefits outweigh the risks. Clarithromycin has been shown to cause birth defects in animals.
• Breastfeeding⁚ Clarithromycin passes into breast milk. It is not known whether clarithromycin is harmful to nursing infants. Therefore, clarithromycin should only be used during breastfeeding if the potential benefits outweigh the risks.

It is important to tell your doctor about all of your medical conditions, including liver disease, kidney disease, myasthenia gravis, and pregnancy or breastfeeding. This will help your doctor determine if clarithromycin is right for you.

Drug Interactions

Clarithromycin can interact with a number of other medications, including⁚

• Ergotamine and dihydroergotamine⁚ Clarithromycin can increase the levels of ergotamine and dihydroergotamine in the blood, which can lead to serious side effects, such as heart attack and stroke.
• Pimozide⁚ Clarithromycin can increase the levels of pimozide in the blood, which can lead to serious side effects, such as irregular heart rhythm and sudden death.
• Cisapride, terfenadine, and astemizole⁚ Clarithromycin can increase the levels of cisapride, terfenadine, and astemizole in the blood, which can lead to serious side effects, such as irregular heart rhythm and sudden death.
• Quinidine and disopyramide⁚ Clarithromycin can increase the levels of quinidine and disopyramide in the blood, which can lead to serious side effects, such as irregular heart rhythm and sudden death.
• Amiodarone and sotalol⁚ Clarithromycin can increase the levels of amiodarone and sotalol in the blood, which can lead to serious side effects, such as irregular heart rhythm and sudden death.
• CYP3A4 inhibitors⁚ Clarithromycin is metabolized by the CYP3A4 enzyme. CYP3A4 inhibitors, such as ritonavir, indinavir, nelfinavir, and saquinavir, can increase the levels of clarithromycin in the blood, which can lead to increased side effects.

It is important to tell your doctor about all of the medications you are taking, including prescription and over-the-counter medications, vitamins, and herbal supplements. This will help your doctor determine if clarithromycin is right for you and to adjust your dose if necessary.

Overdosage

Overdosage of clarithromycin can lead to the following symptoms⁚

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Headache
• Confusion
• Seizures
• Coma

If you suspect that someone has overdosed on clarithromycin, call 911 or your local poison control center right away. Treatment for clarithromycin overdose may include⁚

• Gastric lavage
• Activated charcoal
• Intravenous fluids
• Electrolyte monitoring
• Anticonvulsants

The prognosis for clarithromycin overdose is generally good. However, in severe cases, overdose can lead to death.

Missed Dose

If you miss a dose of clarithromycin, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses at the same time. It is important to take clarithromycin exactly as prescribed by your doctor. Skipping doses can reduce the effectiveness of the medication and increase the risk of developing antibiotic resistance. If you have any questions about what to do if you miss a dose of clarithromycin, talk to your doctor or pharmacist.

Pregnancy and Lactation

Pregnancy

Clarithromycin should only be used during pregnancy if the potential benefits outweigh the risks. Clarithromycin has been shown to cause birth defects in animals. There are no adequate and well-controlled studies of clarithromycin use in pregnant women. However, a number of case reports have described the use of clarithromycin during pregnancy without any apparent adverse effects. If you are pregnant or planning to become pregnant, talk to your doctor about the risks and benefits of taking clarithromycin.

Lactation

Clarithromycin passes into breast milk. It is not known whether clarithromycin is harmful to nursing infants. Therefore, clarithromycin should only be used during breastfeeding if the potential benefits outweigh the risks. If you are breastfeeding or planning to breastfeed, talk to your doctor about the risks and benefits of taking clarithromycin. Your doctor may recommend that you stop breastfeeding while you are taking clarithromycin.

Storage and Handling

Clarithromycin tablets and extended-release tablets should be stored at room temperature, between 59°F and 86°F (15°C and 30°C). Clarithromycin granules for oral suspension should be stored at room temperature, between 59°F and 86°F (15°C and 30°C), or in a refrigerator, between 36°F and 46°F (2°C and 8°C). Do not freeze clarithromycin. Keep clarithromycin out of the reach of children. Dispose of any unused clarithromycin after the expiration date has passed. Do not flush clarithromycin down the toilet or pour it down the drain. Ask your pharmacist how to properly dispose of clarithromycin.

Patient Education

Clarithromycin is a prescription antibiotic used to treat a variety of bacterial infections. It is important to take clarithromycin exactly as prescribed by your doctor. Do not take more or less of the medication than prescribed, and do not take it for longer than prescribed. Clarithromycin can be taken with or without food. However, it is best to take it with food to reduce the risk of stomach upset; Clarithromycin can cause side effects, such as nausea, vomiting, diarrhea, abdominal pain, and headache. These side effects are usually mild and go away within a few days. However, if you experience any severe side effects, such as difficulty breathing, hives, or swelling of the face, mouth, or throat, stop taking clarithromycin and contact your doctor right away. Clarithromycin can interact with a number of other medications. It is important to tell your doctor about all of the medications you are taking, including prescription and over-the-counter medications, vitamins, and herbal supplements. Clarithromycin should not be taken by people who are allergic to it or to any other macrolide antibiotics. It should also be used with caution in people with liver or kidney disease, myasthenia gravis, or a history of QT prolongation. If you have any questions about clarithromycin, talk to your doctor or pharmacist.