Antimicrobials
Clarithromycin

Clarithromycin

Medium
Moderate

Spectrum of Activity

Dosing

General Information

  • CAP (use Azithromycin instead)
  • Pertussis (use Azithromycin instead)
  • H. pylorI and mycobacterial infections

Monitor QTc in patients with increased risk

  • Neutropenia
  • GI upset
  • Prolongation of QTc interval
  • Drug interactions

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

  •  CYP450 interactions ++ (inhibits 3A4 and PGP)
  • Other QTc prolonging agents
  • Statins - increased rhabdo
  • CCBs - hypotension, AKI
  • Colchicine - increased bone marrow toxicity
  • Increased anticonvulsant levels
  • Increased tacrolimus levels

Very high tissue penetration and concentration intracellularly.

Offers little advantage over Azithromycin for common infections such as pneumonia and pertussis. May consider Clarithromycin in MAC.

Clarithromycin used for H. pylori infections.

Antimicrobial class: Macrolide

Pregnancy category: C

Average serum half life: 5 hours

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor