Clarithromycin - A Review
DR T R RAMANUJAM M.D., C.MI.Biol (Lond)
ANTIMICROBIAL ACTIVITY
CLINICAL PHARMACOKINETICS
CLINICAL EFFICACY
TOLERABILITY PROFILE
ADVERSE EFFECTS & DRUG INTERACTIONS
CHOOSING HOOSING MACROLIDES
CONCLUDING SUMMARY
BRIIGHTER SIDE OF CLARITHROMYCIN
DARKER SIDE OF CLARITHROMYCIN
CURRENT TRENDS IN MICROLIDE USE
BRIGHTER SIDE OF CLARITHROMYCIN
- Clarithromycin exhibits BACTERICIDAL activity against H.influenzae, S.pneumoniae, S.pyogenes,S.agalactia etc.,
- It has good activity against many respiratory pathogens causing atypical pneumonia specifically very effective against L.pneumophiliae etc.,
- In addition to its antibacterial activity, clarithromycin exhibits
(1) Improvement in immune function
(2) reduced the visco-elastic property of the mucus and sputum
- Claritheomycin has consistent p.o absorption with good oral bioavailability exhibiting high concentrations in lung, tonsils, nasal tissue, middle ear, and WBCs etc.,
- No need for adjustment of dosage in older patients and with mild hepatic impairment and renal impairment (except in Creatinine 30ml/mt)
- Clarithromycin has greater activity against opportunistic infections associated with AIDS like MAC, T.gondii, and Cryptosporidiosis with very little or no interaction with new Anti HIV proteases used in AIDS.
- Clarithromycin has greater activity against T.gondii when combined with pyrimethammine although secondary to cotrimoxazole
- Clarithromycin has excellent activity against M.chelonae as mono-therapy in this refractory disseminated infection
- Recent studies have clearly shown that clarithromycin is highly effective against B.burgdorferi the tick borne Lyme disease and associated arthritis.
- Clarithromycin produced better clinical success and bacteriological eradication rate in chest infections like Acute bronchitis, Acute Exacerbation of Chronic Bronchitis (AECB), Community acquired pneumonia, otitis media etc.,
- Clarithromycin is an important second line drug in leprosy and given in combination with minocycline.
