From the Guidelines
Yes, clarithromycin is a macrolide antibiotic. It belongs to the macrolide class of antibiotics which are characterized by a large lactone ring structure in their chemical composition. Clarithromycin works by binding to the 50S subunit of bacterial ribosomes, inhibiting protein synthesis and thereby preventing bacterial growth.
Key Points
- It is commonly prescribed to treat various bacterial infections including respiratory tract infections, skin infections, and Helicobacter pylori infections (often as part of combination therapy for peptic ulcer disease) 1.
- Clarithromycin is typically available in oral formulations, with common dosages ranging from 250-500 mg twice daily, depending on the infection being treated.
- The duration of treatment usually ranges from 7-14 days.
- Like other macrolides, clarithromycin can interact with several medications through the cytochrome P450 enzyme system, so it's essential to review potential drug interactions before use 1.
- Common side effects include gastrointestinal disturbances such as nausea, diarrhea, and abdominal pain.
- The most recent and highest quality study, published in 2020, confirms the effectiveness of clarithromycin in treating nontuberculous mycobacterial pulmonary disease, with a focus on preventing the development of macrolide resistance 1.
Important Considerations
- Clarithromycin is contraindicated in patients with a history of hypersensitivity to any macrolide agent 1.
- It should not be administered concomitantly with certain medications, such as astemizole, cisapride, pimazole, or terfenadine, due to the risk of adverse interactions 1.
- Patients with impaired renal function may require dosage adjustments to avoid elevated drug concentrations 1.
From the FDA Drug Label
Clarithromycin is a macrolide antimicrobial drug [see Microbiology (12.4)]. Clarithromycin extended-release tablets is a macrolide antimicrobial indicated for mild to moderate infections caused by designated, susceptible bacteria in the following: Clarithromycin is a semi-synthetic macrolide antimicrobial for oral use.
Yes, clarithromycin is a macrolide 2, 2, 2.
From the Research
Classification of Clarithromycin
- Clarithromycin is classified as a macrolide antimicrobial drug, structurally related to erythromycin 3.
- It is an acid-stable orally administered macrolide, with a broad spectrum of antimicrobial activity 3.
- Clarithromycin is also referred to as a broad spectrum macrolide antibacterial agent 4.
Comparison with Other Macrolides
- Clarithromycin is compared to other macrolides, such as azithromycin, in terms of its efficacy and pharmacokinetics 5.
- Azithromycin and clarithromycin are erythromycin analogues with improved pharmacodynamic properties 5.
- Clarithromycin is several-fold more active in vitro than erythromycin against gram-positive organisms 5.
Mechanism of Action
- Macrolides, including clarithromycin, reversibly bind to the 23S rRNA and inhibit protein synthesis by blocking elongation 6.
- The ketolides, a new group of 14-membered macrolides, have a similar mechanism of action to macrolides 6.
Clinical Use
- Clarithromycin is used extensively for the treatment of respiratory tract infections, sexually transmitted diseases, and Helicobacter pylori-associated peptic ulcer disease 7.
- It is also effective against atypical mycobacteria, giving new hope to what has become a difficult group of infections to treat 5.