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Clarithromycin (Biaxin)
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Clarithromycin

Clarithromycin is used to treat bacterial infections in many different parts of the body. It is also used in combination with other medicines to treat duodenal ulcers caused by H. pylori. This medicine is also used to prevent and treat Mycobacterium avium complex (MAC) infection.

Other names for this medication:
Abbotic, Adel, Aeroxina, Althromicin, Apo-clarix, Bacterfin, Biclar, Bicrolid, Binoclar, Biotclarcin, Bremon, Bremon unidia, Ciclinil, Cidoclar, Clabact, Clabel, Clacee, Clacina, Clacine, Clactirel, Clamycin, Clarimac, Clarimax, Clarimed, Clarimycin, Claripen, Clariston, Claritab, Claritron, Claritrox, Claritt, Clariva, Clariwin, Clarix, Clarocin, Clarogen, Claromac, Claromycin, Claron, Clarosip, Claryl, Clarytas, Clasine, Clathrocyn, Clatic, Claxid, Cleanomisin, Cleron, Clonocid, Clormicin, Derizic, Egelif, Eliben, Emimycin, Eracid, Euromicina, Ezumycin, Finasept, Fromilid, Geromycin, Gervaken, Glartin, Hecobac, Heliclar, Helimox, Helozym, Infex, Iset, Italclar, Kailasa, Kalecin, Kalixocin, Karid, Karin, Klabax, Klabet, Klabion, Klarifor, Klarigen, Klariger, Klarimac, Klarimax, Klarit, Klarith, Klarithran, Klarithrin, Klaritpharma, Klax, Klaz, Klazidem, Klerimed, Kleromicin, Klonacid, Kofron, Krobicin, Laricid, Larithro, Larizin, Laromin, Lekoklar, Likmoss, Lyoclar, Macladin, Maclar, Macrobid, Macrol, Macromicina, Mononaxy, Monozeclar, Naxy, Neo-clarosip, Neo-klar, Nexium hp7, Nutabact, Odycin, Onexid, Opeclacine, Orixal, Pre-clar, Preclar, Quedox, Rocin, Rodizim, Rolacin, Rolicytin, Synclar, Taclar, Uniklar, Veclam, Vikrol, Xylar, Zeclar, Zeclaren

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Cipro, Zitromax, Erythromycin, Azithromycin, Roxithromycin, Erythrocin, Zmax, Zithromax, Ery-Tab, Dificid, Erythrocin Stearate Filmtab, Eryc, EryPed, Erythrocin Lactobionate, Ilosone, PCE Dispertab

 

Also known as:  Biaxin.

Description

Clarithromycin (generic name: clarithromycin; brand names include: Maclar / Klaricid / Klacid / Clarimac / Claribid) is used to treat many different types of bacterial infections affecting the skin and respiratory system, including: Strep throat, Pneumonia, Sinusitis (inflamed sinuses), Tonsillitis (inflamed tonsils), Acute middle ear infections, Acute flare-ups of chronic bronchitis.

It also is used to treat and prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. It is used in combination with other medications to eliminate H. pylori, a bacteria that causes ulcers.

It also is used sometimes to treat other types of infections including Lyme disease (an infection that may develop after a person is bitten by a tick), crypotosporidiosis (an infection that causes diarrhea), cat scratch disease (an infection that may develop after a person is bitten or scratched by a cat), Legionnaires' disease (a type of lung infection), and pertussis (whooping cough; a serious infection that can cause severe coughing). It is also sometimes used to prevent heart infection in patients having dental or other procedures.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Clarithromycin works by stopping the growth of or killing sensitive bacteria by interfering with their protein synthesis.

Dosage

The recommended daily dosage is 15 mg/kg/day divided every 12 hours for 10 days (up to the adult dose). Refer to dosage regimens for mycobacterial infections in pediatric patients for additional dosage information.

For the treatment of disseminated infection due to Mycobacterium avium complex (MAC), Clarithromycin Filmtab and Clarithromycin Granules are recommended as the primary agents. Clarithromycin Filmtab and Clarithromycin Granules should be used in combination with other antimycobacterial drugs (e.g. ethambutol) that have shown in vitro activity against MAC or clinical benefit in MAC treatment.

For treatment and prophylaxis of mycobacterial infections in adults, the recommended dose of Clarithromycin is 500 mg every 12 hours.

For treatment and prophylaxis of mycobacterial infections in pediatric patients, the recommended dose is 7.5 mg/kg every 12 hours up to 500 mg every 12 hours.

Clarithromycin therapy should continue if clinical response is observed. Clarithromycin can be discontinued when the patient is considered at low risk of disseminated infection.

Overdose

Overdose symptoms may include severe stomach pain, nausea, vomiting, or diarrhea.

Storage

Store Clarithromycin XL Filmtab at 20 to 25 degrees C (68 to 77 degrees F). Excursions permitted to 15 to 30 degrees C (59 to 86 degrees F).

Side effects

The most common side effects associated with Clarithromycin are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Discontinue immediately if hepatitis or severe hypersensitivity reactions occurs. Severe renal impairment. Proarrhythmic conditions (eg, hypokalemia, hypomagnesemia, bradycardia); avoid. Myasthenia gravis. History of porphyria; avoid concomitant ranitidine bismuth citrate. Elderly. Pregnancy (Cat.C): usually not recommended. Nursing mothers.

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  All strains survived within a pH 6.0-9.0. The minimal inhibitory concentrations of the extract against strains ranged 0.064-0.256 mg/mL. Urushiol caused separation of the membrane and lysis of H. pylori within 10 minutes. Urushiol (0.128 mg/mL × 7 days) did not cause complications on mice. The eradication rates were 33% in the urushiol monotherapy, 75% in the triple therapy (omeprazole + clarithromycin + metronidazole), and 100% in the urushiol + triple therapy, respectively. H. pylori-induced gastritis was not changed by urushiol but reduced by eradication. Only the expression of interleukin-1β in the gastric tissue was significantly increased by H. pylori infection and reduced by the urushiol and H. pylori eradication (p = .014).

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Cutaneous infection with Mycobacterium chelonae is an uncommon disease, although this atypical mycobacterium is an acid-fast bacillus ubiquitous in the environment. It is often misdiagnosed and treated as a fungal or common bacterial infection. We report a case of disseminated atypical mycobacterial skin infection of a 72-year-old woman who was treated with different topical and systemic antimycotic and antibiotic drugs over a period of 5 months without remarkable improvement. Eventually, repeated tissue cultures on special medium and performance of PCR led to the diagnosis of M. chelonae infection. The patient was treated successfully with oral clarithromycin within 8 weeks. In case of abscessing cutaneous infection, M. chelonae should be considered in the differential diagnosis of prolonged disease when common antibiotics are not effective after 2-4 weeks of treatment.

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Eradication of Helicobacter pylori usually consists of a 7-day course of triple therapy including metronidazole or amoxicillin plus clarithromycin plus a proton pump inhibitor. We report about a rare adverse event of Hp eradication in a patient with moderate chronic and moderate active pangastritis. Shortly after the end of treatment cholestatic hepatitis occurred which was most likely related to clarithromycin, perhaps enhanced by amoxicillin. Since liver dysfunction was self-limited, no further treatment was required. In summary, clinicians should be aware about the presented rare adverse event of Helicobacter pylori eradication treatment for a close monitoring of those patients and rapid management of acute liver failure.

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Geographic distribution of sensitivity rates was not homogeneous for some antibiotics. Around 24% of strains were betalactamase producers, requiring higher MICs of antibiotics such as loracarbef, cefprozil and cefaclor than non betalactamase producers. Nevertheless MICs of ceftibuten, cefpodoxime and cefixime were similar in both betalactamase producers and non-producers. Five strains (1.25%) were beta -lactamase (2), but resistant to ampicillin (MIC > or = 8 mg/L) and to amoxicillin/clavulanic acid (MIC > or = 4/2 mg/L). Only three strains showed intermediate sensitivity to chloramphenicol. These strains and four others were inhibited with > or = 4 mg/L of tetracycline. Only one strain was resistant to tetracycline (MIC: 64 mg/L) and to rifampin (MIC: 256 mg/L). All strains were sensitive to azithromycin (MICs < or = 4 mg/L) and all were sensitive to ciprofloxacin and trovafloxacin (MICs < or = 0.5 mg/L). However, ten strains (2.5%) were resistant to nalidixic acid (MIC > or = 4 mg/L).

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From January to December 2012, a total of 599 strains causing adult community-acquired respiratory tract infection were collected from 11 hospitals, including 381 Streptococcus pneumonia, 137 Haemophilus influenza, and 81 Moraxella catarrhalis. The minimal inhibitory concentration (MIC) of antibacterial agents was determined by agar dilution method.

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There was some evidence for a short term association for first MI but none for a long term association for any outcome.

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Flourescently labeled oligonucleotdie probes that target ribosomal RNA were utilized in the FISH procedure. Ninety-one gastric biopsy specimens were tested by FISH and by histology using hematoxylin-eosin (H-E) and Geimsa stains. Furthermore, clarithromycin resistance in 39 of the 91 specimens was examined by FISH.

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Reported observed intention-to-treat eradication rates for ranitidine bismuth citrate plus clarithromycin for 14 days range from 70-86% in studies from the USA and 82-96% in multinational studies carried out primarily in Europe. Two double-blind head-to-head comparisons with omeprazole plus clarithromycin or amoxycillin have shown that ranitidine bismuth citrate plus clarithromycin gives considerably higher eradication rates than the omeprazole based regimens. Ongoing studies will define the efficacy of shorter duration dual therapies and provide further data on two antibiotics with ranitidine bismuth citrate. The possibility that ranitidine bismuth citrate may help in the eradication of resistant organisms and even in the prevention of primary resistance requires further work to expand the preliminary in vitro observations. In the meantime, it can be concluded that ranitidine bismuth citrate, when used in conjunction with clarithromycin for 14 days, is an effective therapy for the eradication of H. pylori.

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We initiated a prospective trial of an azithromycin-containing regimen for the treatment of human immunodeficiency virus-negative patients with Mycobacterium avium complex (MAC) lung disease; the initial 4 months of therapy were with azithromycin (600 mg/d) alone. The primary study endpoint was microbiological response measured at 4 and 6 months of therapy. Of 29 patients enrolled in the study, 23 completed therapy. Fifty-two percent of these 23 patients were male, and 65% were smokers. All 23 patients were older than 45 years of age; 83% had bilateral disease, and 48% had fibrocavitary disease. Macrolide (clarithromycin)-susceptible MAC isolates were recovered from these 23 patients before treatment. Cultures of sputum from 38% of these patients became negative, and the positivity of cultures of sputum from 76% of these patients was significantly reduced. Sixty-eight percent of sputum cultures were strongly positive (> 200 colonies) before therapy, while only 27% were strongly positive after therapy. Although most patients continued to receive 600 mg of azithromycin/d, the high incidence of gastrointestinal side effects (76%) and altered hearing (41%) suggests the need for lower or less frequent dosing. Macrolide (clarithromycin) resistance did not develop in any MAC isolates during monotherapy. These results, which demonstrate that azithromycin is active against MAC pulmonary disease, provide a rationale to include this drug in the initial multidrug regimens recommended for the treatment of this disease.

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Clarithromycin, amoxicillin, and a pump proton inhibitor are the most common drugs recommended as first-line triple therapy for H.pylori treatment, which results in eradication rates close to 80%, varying regionally, principally due to emergency cases and increases of clarithromycin resistant strains. Nucleotide substitutions at the H. pylori domain V of the 23S rRNA fraction are involved in the macrolide resistance and the A2142G and A2143G mutations are predominant in clinical isolates worldwide including in Brazil. As H. pylori culture is fastidious, we investigated the primary occurrence of H. pylori A2142G and A2143G rDNA 23S mutations using a molecular approach directly on gastric biopsies of dyspeptic patients consecutively attended at Hospital das Clinicas of Marilia, São Paulo, Brazil.

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In spite of Buy Amoxicillin Online higher initial antimicrobial costs, triple therapy with lansoprazole, amoxicillin and clarithromycin is more cost effective than dual therapy because of a higher eradication rate and greater symptom relief.

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Two hundred and fifteen subjects were randomised. Metronidazole and Buy Roxithromycin clarithromycin containing regimens achieved high cure rates: 94 of 97 (96.9%, 95% CI 93.5% to 100%) and 93 of 98 (94.9%, 95% CI 90.5% to 99.3%) by per-protocol and 88.9% (95% CI 83.0% to 94.8%) and 88.8% (95% CI 82.8% to 94.8%) by intention-to-treat, respectively. Amoxicillin, metronidazole and clarithromycin resistance rates were 1.5%, 45.5% and 26.5%, respectively. Only clarithromycin resistance reduced treatment success (e.g., susceptible 98.6%, resistant 76.9%, p=0.001). Adverse events were more common in the metronidazole group.

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In populations Buy Cheap Generic Zithromax with high levofloxacin resistance, 14-day second-line LBAE regimen resulted in an unsatisfactory efficacy in patients resistant to NBQT despite good safety and compliance.

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Here we report a case of a 55-year Caucasian man, who improved the metabolic profile after the treatment for Helicobacter pylori eradication. In particular, we report the changes in Buy Amoxicillin Lloyds homeostatic model assessment of insulin resistance, fatty liver index and echographic liver pattern. We hypothesize the co-factorial role of H. pylori in the mechanisms involved in non-alcoholic fatty liver disease pathogenesis and insulin resistance, by the cytokine serum changes. If this correlation is confirmed, the H. pylori treatment may represent an option in the clinical management of liver steatosis.

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For the eradication of Helicobacter pylori using dual therapy, the combination of a PPI with clarithromycin is clearly superior to PPI and amoxicillin. At the present time, a modified triple therapy, largely a PPI plus macrolide plus imidazole antibiotics, should be given preference as a cure of Helicobacter Buy Cephalexin Dogs pylori infection. The short--one week--duration of the treatment means better tolerability, fewer side-effects and improved patient compliance. The high cure rate achieved with this form of treatment results in a favourable cost-benefit ratio. Overall, this form of therapy should overcome the reservations, still to be found, regarding the use of Helicobacter pylori eradication as optimal treatment of patients with peptic ulcer.

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The severity of fatigue, cough, dyspnea, sputum and pleuritic chest pain were self-scored and recorded daily for 14 days and on days 30 and 42. Each symptom was scored on a scale of 0 to 5. The sum of the five symptom scores had a range of 0 to 25 and was transformed into a value from Where Buy Metronidazole zero to 100 by multiplying by four.

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We studied the efficacy of the long-term administration of 14-membered ring macrolides in treating patients with diffuse panbronchiolitis (DPB) (34 patients) and bronchiectasis (BE) (40 patients). Oral administration of erythromycin (400 or 600 mg), roxithromycin (150 or 300 mg) or clarithromycin (200 or 400 mg) given daily for at least 2 months, was evaluated. The efficacy of erythromycin, roxithromycin, and clarithromycin in DPB was 19/24 (79%), 6/7 (86%), and 2/3 (67%), respectively. Efficacy of these agents in BE exceeded 50%. We determined the effect of these macrolides on the activity of polymophonuclear leukocytes (PMNs) obtained from healthy volunteers. There were no significant differences between the effects of these 14-membered ring macrolides and josamycin, a 16-membered ring macrolide which was previously found to Buy Tetracycline For Fish be ineffective in treating DPB. Thus, the effectiveness of the 14-membered ring macrolides in treating DPB appears to depend on mechanism(s) other than alterations in PMN activity.

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Agar dilution with incubation in air and CO2 was used to determine the MICs of erythromycin, dirithromycin, azithromycin, clarithromycin, roxithromycin, and clindamycin for 79 penicillin-susceptible, 72 penicillin-intermediate, and 74 penicillin-resistant pneumococci (158 erythromycin-susceptible and 67 erythromycin-resistant pneumococci). MICs obtained in air were usually 1 to 3 dilutions lower than those obtained in CO2. In air, the respective MICs at which 50% (MIC50s) and Where To Buy Cefadroxil 90% (MIC90s) of penicillin-susceptible, -intermediate, and -resistant strains are inhibited were as follows: erythromycin, 0.016 and 0.5, 0.03 and > 64, and 2 and > 64 microg/ml; dirithromycin, 0.03 and 0.5, 0.06 and > 64, and 8 and > 64 microg/ml; azithromycin, 0.03 and 0.5, 0.06 and > 64, and 2 and > 64 microg/ml; clarithromycin, 0.016 and 0.06, 0.03 and > 64, and 2 and > 64 microg/ml; roxithromycin, 0.06 and 2, 0.06 and > 64, and 2 and > 64 microg/ml; and clindamycin, 0.03 and 0.06, 0.06 and > 64, and 0.06 and > 64 microg/ml. The MICs of erythromycin, azithromycin, and dirithromycin were very similar; however, clarithromycin MICs were generally 1 to 2 dilutions lower and roxithromycin MICs were 1 to 2 dilutions higher than those of the other compounds tested. Strains resistant to one macrolide were resistant to all macrolides; however, not all macrolide-resistant strains were resistant to clindamycin, and 32 macrolide-resistant (MICs, > or = 28 microg/ml), clindamycin-susceptible (MICs, < or = 0.25 microg/ml) strains were encountered. Time-kill testing of six strains showed similar killing kinetics for all compounds, with 99.9% killing of all strains observed with the compounds only at or above the MIC after 24 h.

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Antibiotic resistance and duration of therapy influence the success of proton-pump inhibitor-containing Helicobacter pylori eradication therapy. Clarithromycin resistance is associated with treatment failure.

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We describe the in vitro activities of the combinations of carvacrol and thymol with antibiotics (azithromycin, clarithromycin, minocycline and tigecycline) and antifungal agents (amphotericin B, caspofungin, itraconazole and terbinafine) against 23 isolates of the oomycete Pythium insidiosum. The assays were based on the M38-A2 technique and checkerboard microdilution. Based on the mean FICI values, the main synergies observed were combinations of carvacrol+itraconazole and thymol+itraconazole (96%), thymol+clarithromycin (92%), carvacrol+clarithromycin (88%), thymol+minocycline (84%), carvacrol+minocycline (80%), carvacrol+azithromycin (76%), thymol+azithromycin (68%), carvacrol+tigecycline (64%) and thymol+tigecycline (60%). In conclusion, we found that combinations of carvacrol or thymol with these antimicrobial agents might provide effective alternative treatments for cutaneous pythiosis due to their synergistic interactions. Future in vivo experiments are needed to elucidate the safety and therapeutic potential of these combinations.