References
Drug breakdown: Clarithromycin – Earn your CPD
Abstract
In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #clarithromycin
Dr Sharon Rees @reesprescribe
Day 1: The first macrolide antibiotic, erythromycin, was isolated from streptomyces erythraeus in 1952. #clarithromycin is a semi-synthetic derivative, marketed in the 90s, with increased bioavailability, longer t½ and a superior adverse drug reaction (ADR) profile, especially re Gastrointestinal (GI) issues.
Dr Sharon Rees @reesprescribe
(cont) #clarithromycin has greater lipophilicity allowing increased penetration into lung tissue, and enhanced treatment of intracellular pathogens such H. influenzae.
Dr Sharon Rees @reesprescribe
Day 2: Indications #clarithromycin include upper & lower RTIs, H. pylori, penicillin alternative for conditions such as otitis media, strep throat, skin and soft tissue infections, and Lyme disease. Adult dose range oral 250-500 mg x2 daily. Children > 1 month weight-dependent dose.
Dr Sharon Rees @reesprescribe
(cont) Bacterial resistance to second generation macrolides such as #clarithromycin is increasing; common mechanisms are up regulation of bacterial efflux pumps and reduced drug binding affinity; an example would be because of bacterial modification of the target ribosome unit.
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