Brand Name: Biaxin XL Generic Name: Clarithromycin Classification: Drugs for Mycobacterium Avium Complex Infection Recommended Dosage, Route, and Frequency: Mild to Moderate Infections

Brand Name: Biaxin XL Generic Name: Clarithromycin Classification: Drugs for Mycobacterium Avium Complex Infection Recommended Dosage, Route, and Frequency: Mild to Moderate Infections Adult: PO 250–500 mg b.i.d. or 500 mg XL q.d. for 10–14 d Child: PO 7.5 mg/kg q12h Mycobacterial Infections Adult: PO 500 mg q12h Child: PO 7.5 mg/kg q12h H. pylori Infections Adult: PO 500 mg b.i.d. to t.i.d. Renal Impairment Clcr 30 mL/min, decrease dose by ½ or double the dosing interval Drug Action: A semisynthetic macrolide antibiotic that binds to the 50S ribosomal subunit of susceptible bacterial organisms and thus inhibits protein synthesis of the bacteria. Absorption: Readily absorbed from GI tract; 50% reaches the systemic circulation. Peak: 2–4 h. Distribution: Widely distributes into most body tissue (excluding CNS); high pulmonary tissue concentrations. Metabolism: Partially metabolized in the liver; active 14-OH metabolite acts synergistically with the parent compound against H. influenzae. Elimination: 20% excreted unchanged in urine; 10–15% of 14-OH metabolite excreted in urine. Half-Life: 3–5 h. Drug-Drug and Drug-Food Interactions: Drug: May increase theophylline levels; drugs known to interact with erythromycin like digoxin, carbamazepine, triazolam, warfarin, ergotamine and dihydroergotamine should be monitored carefully for increased levels and toxicity; pimozide may increase risk of arrhythmias. Indications: Treatment of upper respiratory, lower respiratory infections; acute maxillary sinusitis; otitis media; and skin and soft tissue infections caused by clinically significant aerobic and anaerobic gramnegative and gram-positive organisms, including S. aureus, H. influenzae, S. pneumoniae, M. catarrhalis, S. pyogenes, M. pneumoniae. Prevention and treatment of Mycobacterium avium complex (MAC) infections in patients with HIV. Used in combination for Helicobacter pylori. Contraindications: Hypersensitivity to clarithromycin, erythromycin, or any other macrolide antibiotics; patients receiving pimozide; suspected or potential bacteremias; acute porphyria; severe hepatic or biliary disease; pregnancy (category C). Safety and efficacy in children 6 y not established. Side Effects: Adverse Effects: GI: Diarrhea, abdominal discomfort, nausea, abnormal taste, dyspepsia. Hematologic: Eosinophilia. CNS: Headache. Skin: Rash, urticaria. Nursing Responsibilities: Assessment • Assess patient for infection. • Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results. • Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of Clostridium difficile-associated diarrhea (CDAD). • Assess patient for skin rash frequently during therapy. • Discontinue clarithromycin at first sign of rash; may be life-threatening. Stevens-Johnson syndrome may develop. Treat symptomatically; may recur once treatment is stopped. • Ulcers: Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate. Diag