Spectrum: Local Antimicrobial Stewardship, for Alberta Children's Hospital

Clarithromycin

C. diff Risk

Medium

Oral Bioavailability

Excellent

Approximate Cost

$1/day

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Renal

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

Hepatic

Adjustment not needed as long as renal function is normal

General Pediatric

15 mg/kg/DAY divided q12h. Max: 500mg/dose.

PO Severe

15 to 30 mg/kg/DAY divided q12h. Max: 500mg/dose.

General Information

Common Usage

Common Usage

CAP, Pertussis, URTI, H. pylori, and mycobacterial infections

Drug Monitoring

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

Adverse Effects

  • GI upset, diarrhea

  • Rash

  • Prolongation of QTc interval

Major Interactions

Major Interactions

Substrate of CYP3A4.

Multiple CYP450 interactions possible - consult a pharmacist for more detail. May increase digoxin, carbamazepine level. Use caution with QTc prolonging medications.

Pharmacology

Pharmacology

Antimicrobial class: Macrolide

Average serum half life: Adult: Clarithromycin: 3-7 hours
14-OH-clarithromycin (active metabolite): 5-9 hours

Route of Elimination: Urine (20-40% as unchanged drug, additional 10%-15% as active metabolite); feces (29% to 40% mostly as metabolites)