C. diff Risk


Oral Bioavailability


Approximate Cost


Spectrum Of Activity


500mg PO BID

Dose adjust for CrCl < 30

Creatinine Clearance >30mL/min/1.73m²Creatinine Clearance 10-30mL/min/1.73m²<10mL/min/1.73m²HemodialysisPeritoneal Dialysis7.5 mg/kg/dose PO Q12H
Maximum: 500mg/dose4 mg/kg/dose PO Q12H4 mg/kg/dose PO daily4 mg/kg/dose PO daily
Give after dialysis on dialysis days4 mg/kg/dose PO daily


General Information

Adverse Effects

  • GI effects

  • Cholestatic jaundice

  • QT prolongation

  • Allergic reaction

Drug Monitoring


  • Consider periodic LFTs with prolonged use

  • Baseline Cr (dose-adjustment assessment)


  • Hypersensitivity

  • GI effects

  • Drug interactions

  • QT prolongation with risk factors

Major Interactions

  • 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

Additional Information

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

Common Usage

  • CAP

  • Pertussis

  • URTI

  • H. pylori

  • Mycobacterial infections