Properties
Clarithromycin, the active ingredient of Clarem® is a semi synthetic derivative of erythromycin A.
Indications
Clarem® is indicated for the treatment of respiratory tract infections, acute otitis media, skin and soft tissue infections, eradication of H. Pylori, disseminated mycobacterial infections, and for the prevention of disseminated Mycobacterium avium complex (MAC) in patients with advanced HIV infections and prevention of heart infections after dental and other surgical procedures.
Dosage
Adult and children older than 12 years: The usual does is 250mg twice daily for 7 days although this may be increased to 500mg twice daily for up to 14 days in severe infections.
Elderly: as for adults.
Renal impairment: Dosage adjustment are required in patients with severe renal impairment (creatinine clearance <30 ml/min). If adjustment is necessary, the total daily dosage should be reduced by half, e.g. 250mg once daily or 250mg once daily or 250mg twice daily in more severe infections.
Side-effects
There have been reported: nausea, dyspepsia, diarrhoea, vomiting, abdominal pain, and paraesthesia, stomatitis, glossitis,headache, arthralgia, myalgia, allergic reactions, central nervous system side-effects and pseudomembranous colitis. As with other macrolides, hepatic dysfunction (which is usually reversible). QT prolongation, ventricular tachycardia and Torsade de Pointes have been rarely reported.