Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Clarithromycin

C. diff Risk

Medium

Oral Bioavailability

Moderate (40 to 70%)

Approximate Cost

$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Pediatric

7.5 mg/kg, PO, q12hr(s). Max dose = 500mg

Renal

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

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)