Spectrum: Local Antimicrobial Stewardship, for Bakersfield Memorial Hospital

Clarithromycin

C. diff Risk

Medium

Oral Bioavailability

Moderate

Approximate Cost

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Renal

Adult

500mg PO BID

General Information

Common Usage

Common Usage

  • CAP

  • Pertussis

  • URTI

  • H. pylorI and mycobacterial infections

Drug Monitoring

Drug Monitoring

Lab

  • Periodic LFTs with prolonged use

Clinical

  • Monitor QTc in patients with increased risk

  • GI effects

  • Hypersensitivity

Adverse Effects

Adverse Effects

  • Neutropenia

  • GI upset/Diarrhea

  • Prolongation of QTc interval

Major Interactions

Major Interactions

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

Additional Information

Additional Information

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

Pharmacology

Pharmacology

Antimicrobial class: Macrolide

Pregnancy category: C

Average serum half life: 5 hours

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor