Clarithromycin

C. diff Risk

Medium

Oral Bioavailability

Moderate

Dosing

eGFR 0 - 10eGFR 10 - 50eGFR > 50500mg PO daily500mg PO q12-24h500mg PO q12h

500mg PO daily

Dose after dialysis on HD days

500mg PO BID

General Information

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

  • Neutropenia

  • GI upset

  • Prolongation of QTc interval

  • Drug interactions

  • CAP

  • Pertussis

  • URTI

  • H. pylorI and mycobacterial infections

Monitor QTc in patients with increased risk

Recommend review of patient medications due to high frequency of significant interactions

  • ¬†CYP450 interactions ++

  • Other QTc prolonging agents

  • Statins - increased rhabdo

  • CCBs - hypotension, AKI

  • Colchicine - increased bone marrow toxicity

  • Increased anticonvulsant levels

  • Increased tacrolimus levels

Antimicrobial class: Macrolide

Pregnancy category: C

Average serum half life: 5 hours

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor