Antimicrobials
Clarithromycin

Clarithromycin

Medium
Moderate
$

Spectrum of Activity

General Information

  • CAP
  • Pertussis
  • URTI
  • H. pylori
  • Mycobacterial infections

Laboratory

  • Consider periodic LFTs with prolonged use
  • Baseline Cr (dose-adjustment assessment)

Clinical

  • Hypersensitivity
  • GI effects
  • Drug interactions
  • QT prolongation with risk factors
  • GI effects
  • Cholestatic jaundice
  • QT prolongation
  • Allergic reaction
  • CYP interactions
  • Other QTc prolonging agents
  • Recommend review of pt medications due to high frequency of significant interactions
  • Statins - increased rhabdo
  • CCBs - hypotension, AKI
  • Colchicine - increased bone marrow toxicity
  • Increased anticonvulsant levels
  • Increased tacrolimus levels

Very high tissue penetration and concentration intracellularly means in vivo activity may not be predicted by in vitro testing

Antimicrobial class: Macrolide

Pregnancy category: C

Average serum half life: 5 hours

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor