Clarithromycin

Clarithromycin - is an erythromycin derivative with slightly greater activity, a longer half-life and higher tissue penetration than erythromycin. Adverse effects are thought to be less common than with erythromycin. Resistance rates in Gram ve organisms limit its use for severe soft tissue infections.

Uses:
Community-acquired pneumonia
Infective exacerbations of COPD
Pharyngeal and sinus infections
Soft tissue infections
Helicobacter pylori eradication as part of combination therapy with a proton
pump inhibitor plus amoxicillin or metronidazole

Administration:
• Orally: 250–500 mg 12 hourly
• IV: 500 mg 12 hourly
Reconstitute in 10 ml WFI.Then make up to 250 ml with glucose
5% or sodium chloride 0.9% and give over 60 min

How not to use clarithromycin:
Should not be given as IV bolus or IM injection

Adverse effects:
Gastrointestinal intolerance
↑ LFTs (usually reversible)

Organ failure:
Renal: no dose reduction necessary in renal failure