▶Zithromax(Pfizer Ltd)
Azithromycin (as Azithromycin dihydrate) 250 mgZithromax
250 mg capsules| 4 capsuleP£ 7. 16 | 6 capsuleP£ 10. 74 DT
=£ 5. 39eiiiiF 328Clarithromycin
lINDICATIONS AND DOSE
Respiratory-tract infections|Mild to moderate skin and
soft-tissue infections|Otitis media
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Neonate: 7. 5 mg/kg twice daily.▶Child 1 month–11 years (body-weight up to 8 kg): 7. 5 mg/kg
twice daily
▶Child 1 month–11 years (body-weight 8–11 kg): 62. 5 mg
twice daily
▶Child 1 month–11 years (body-weight 12–19 kg): 125 mg
twice daily
▶Child 1 month–11 years (body-weight 20–29 kg): 187. 5 mg
twice daily
▶Child 1 month–11 years (body-weight 30–40 kg): 250 mg
twice daily
▶Child 12–17 years: 250 mg twice daily usually for
7 – 14 days, increased to 500 mg twice daily, if required
in severe infections (e.g. pneumonia)
▶BY MOUTH USING MODIFIED-RELEASE MEDICINES
▶Child 12–17 years: 500 mg once daily usually for
7 – 14 days, increased to 1 g once daily, if required in
severe infections (e.g. pneumonia)
▶BY INTRAVENOUS INFUSION
▶Child 1 month–11 years: 7. 5 mg/kg every 12 hours (max.
per dose 500 mg every 12 hours) maximum duration
5 days, switch to oral route when appropriate, to be
administered into a large proximal vein
▶Child 12–17 years: 500 mg every 12 hours maximum
duration 5 days, switch to oral route when appropriate,
to be administered into a large proximal vein
Lyme disease
▶BY MOUTH
▶Child 1 month–11 years: 7. 5 mg/kg twice daily (max. per
dose 500 mg) for 14 – 21 days
▶Child 12–17 years: 500 mg twice daily for 14 – 21 days
Prevention of pertussis
▶BY MOUTH
▶Neonate: 7. 5 mg/kg twice daily for 7 days.▶Child 1 month–11 years (body-weight up to 8 kg): 7. 5 mg/kg
twice daily for 7 days
▶Child 1 month–11 years (body-weight 8–11 kg): 62. 5 mg
twice daily for 7 days
▶Child 1 month–11 years (body-weight 12–19 kg): 125 mg
twice daily for 7 days
▶Child 1 month–11 years (body-weight 20–29 kg): 187. 5 mg
twice daily for 7 days
▶Child 1 month–11 years (body-weight 30–40 kg): 250 mg
twice daily for 7 days
▶Child 12–17 years: 500 mg twice daily for 7 days
Helicobacter pylorieradication in combination with
omeprazole, and amoxicillin or metronidazole
▶BY MOUTH
▶Child 1–5 years: 7. 5 mg/kg twice daily (max. per dose
500 mg)
▶Child 6–11 years: 7. 5 mg/kg twice daily (max. per dose
500 mg)
▶Child 12–17 years: 500 mg twice daily
Acute sinusitis
▶BY MOUTH
▶Child 1 month–11 years (body-weight up to 8 kg): 7. 5 mg/kg
twice daily for 5 days▶Child 1 month–11 years (body-weight 8–11 kg): 62. 5 mg
twice daily for 5 days
▶Child 1 month–11 years (body-weight 12–19 kg): 125 mg
twice daily for^5 days
▶Child 1 month–11 years (body-weight 20–29 kg): 187. 5 mg
twice daily for 5 days
▶Child 1 month–11 years (body-weight 30–40 kg): 250 mg
twice daily for 5 days
▶Child 12–17 years: 250 mg twice daily for 5 days,
alternatively 500 mg twice daily for 5 dayslUNLICENSED USEgDuration of treatment and child
age ranges for acute sinusitis differ from product literature
and adhere to national guidelines.hSee Sinusitis (acute)
p. 697 for further information. Tablets not licensed for use
in children under 12 years; oral suspension not licensed
for use in infants under 6 months. Intravenous infusion
not licensed for use in children under 12 years.
lINTERACTIONS→Appendix 1 : macrolides
lPREGNANCYManufacturer advises avoid, particularly in
thefirst trimester, unless potential benefit outweighs risk.
lBREAST FEEDINGManufacturer advises avoid unless
potential benefit outweighs risk—present in milk.
lHEPATIC IMPAIRMENTAvoid in severe impairment if renal
impairment also present.
lRENAL IMPAIRMENTAvoid if severe hepatic impairment
also present.
▶With oral useAvoidKlaricid XL®or clarithromyin m/r
preparations if estimated glomerularfiltration rate less
than 30 mL/minute/ 1. 73 m^2.
Dose adjustmentsUse half normal dose if estimated
glomerularfiltration rate less than 30 mL/minute/ 1. 73 m^2 ,
max. duration 14 days.
lDIRECTIONS FOR ADMINISTRATIONFor intermittent
intravenous infusion dilute reconstituted solution further
in Glucose 5 %orSodium chloride 0. 9 % to a concentration
of 2 mg/mL; give into large proximal vein over 60 minutes.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Clarithromycin for bacterial
infectionswww.medicinesforchildren.org.uk/clarithromycin-
bacterial-infections
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Clarithromycin Tablets may be prescribed.
Clarithromycin Oral Suspension may be prescribed.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: infusion
Modified-release tablet
CAUTIONARY AND ADVISORY LABELS9, 21, 25
▶Clarie XL(Teva UK Ltd)
Clarithromycin 500 mgClarie XL 500 mg tablets| 7 tabletP
£ 6. 72 DT = £ 6. 72 | 14 tabletP£ 13. 23
▶Klaricid XL(Mylan)
Clarithromycin 500 mgKlaricid XL 500 mg tablets| 7 tabletP
£ 6. 72 DT = £ 6. 72 | 14 tabletP£ 13. 23
▶Xetinin XL(Morningside Healthcare Ltd)
Clarithromycin 500 mgXetinin XL 500 mg tablets| 7 tabletP
£ 6. 72 DT = £ 6. 72 | 14 tabletP£ 13. 23
Granules
CAUTIONARY AND ADVISORY LABELS9, 13
▶Klaricid(Mylan)
Clarithromycin 250 mgKlaricid Adult 250 mg granules sachets|
14 sachetP£ 11. 68
Tablet
CAUTIONARY AND ADVISORY LABELS 9
▶Clarithromycin (Non-proprietary)
Clarithromycin 250 mgClarithromycin 250 mg tablets|
14 tabletP£ 10. 50 DT = £ 1. 07
Clarithromycin 500 mgClarithromycin 500 mg tablets|
14 tabletP£ 21. 50 DT = £ 1. 95330 Bacterial infection BNFC 2018 – 2019
Infection5