Clarithoced
(Clarithromycin 500mg Vial & 500mg Tablet)
INDICATIONS
- Upper and Lower Respiratory Tract infections (Pharyngitis/Tonsillitis, Acute Maxillary Sinusitis, Acute Bacterial Exacerbation of Chronic Bronchitis, CAP)
- Skin & Soft Tissue infections
- Atypical Mycobacterial infections in AIDS patients when oral administration is not possible
- Disseminated Mycobacterial infections due to M. avium or M. intracellulare
- H. pylori infection and duodenal ulcer disease
ADMINISTRATION AND DOSAGE
Injection
- Adults 18 years of age or older: 500 mg BID allowing an interval of 12 hours between doses.
- IV therapy may be limited for up to 2 to 5 days in the very ill patient.
Oral
- Usual recommended dosage in adults and children 12 years of age or older:250mg BID.
- In Severe infections: 500mg BID.
- Usual duration of therapy is 5 to 14 days, excluding treatment of CAP and Sinusitis which require 6 to 14 days of therapy.
British Thoracic Society guideline for the management of Community Acquired Pneumonia (CAP) in adults: Update 2009
Initial empirical treatment regimens for CAP in adult
| Pneumonia Severity | Treatment Site | Preferred Treatment | Alternative Treatment |
|---|---|---|---|
| Moderate severity | Hospital | Amoxicillin 500 mg-1.0g TDS orally plus Clarithromycin 500 mg BD orally If oral administration not possible: Amoxicillin 500 mg TDS IV or Benzylpenicillin 1.2 g QDS IV plus Clarithromycin 500 mg BD IV | Doxycycine 200 mg loading dose then 100 mg orally or Levofloxacin 500 mg OD orally or Moxifloxacin 400 mg OD orally |
| High severity | Hospital (consider critical care review) | Antibiotics given as soon as possible Co-amoxiclav 1.2 g tds IV plus Clarithromycin 500 mg BD IV (If legionella strongly suspected, consider adding Levofloxacin"") | Benzylpenicillin 1.2 g QDS IV plus either Levofloxacin 500 mg BD IV or Ciprofloxacin 400 mg BD IV OR Cefuroxime 1.5g TDS IV or Cefotaxime 1g TDS IV or Ceftriaxone 2g OD IV plus Clarithromycin 500 mg BD IV (If legionella strongly suspected, consider adding Levofloxacin) |
Recommended treatment of microbiologically documented Pneumonia
(Local specialist advice should also be sought")
| Pathogens | Preferred | Alternative |
|---|---|---|
| M. pneumoniae | Clarithromycin 500 mg BD orally or IV | - |
| C. psittaci, C. burnetii | - | Clarithromycin 500 mg BD orally or IV |
| Legionella spp | - | Clarithromycin 500 mg BD orally or IV (or, if necessary, azithromycin in countries where this antibiotic is used for managing pneumonia) |