CLARITHROMYCIN

Antibacterial Activity

Effective against bacteria lacking cell wall (eg. mycoplasma, legionella, chlamydia)
Effective against gram-positive aerobes
Effective against gram-negative aerobes except: campylobacter, pasteurella and some H. influenza
Poor anaerobic coverage

Pregnancy Risk Factor

Category C

Contraindication/Precaution

Hypersensitivity to clarithromycin or macrolides or any component
Not to used be if concomitant cisapride, terfenadine or astemizole usage
Use caution if impaired liver/renal function

Mechanism of Action

Prevents translocation of polypeptide chain by binding to the P site of the ribosomal 50s subunit

Pharmacodynamics/Kinetics

Metabolism: 
liver
Half-life: 
5-7 hours, changes with renal function.
Elimination: 
mostly excreted  in feces (bile), and some in uurine

Dosage 

Children: 

> 28 days old: 7.5 mg/kg PO q12h (max 1 g/d)

Adults:  

PO: 250-500 mg q12h

Dosage In Renal Failure

Creatinine clearance (ml/min):
<10: give 50-75% of usual dose 10-50: give 75% of usual dose 50-80: unchanged >80: unchanged
Dialysis
Hemo: dose post-dialysis: 75% of usual dose x1
CAPD: none