clarithromycin

Adult Dosing .

Dosage forms:  TAB: 250 mg, 500 mg; ER TAB: 500 mg; SUSP: 125 mg per 5 mL, 250 mg per 5 mL

infections, bacterial

[250-500 mg PO q12h x7-14 days]

Alt: 1000 mg ER PO qd x7-14 days; Info: dose, duration varies w/ infection type, severity; not recommended for sinusitis per IDSA guidelines; give ER tab w/ food; do not cut/crush/chew ER tab

chronic bronchitis, acute bacterial exacerbation

[1000 mg ER PO q24h x7 days]

Alt: 250-500 mg PO q12h x7-14 days; Info: give ER tab w/ food; do not cut/crush/chew ER tab

pneumonia, community-acquired

[1000 mg ER PO q24h for at least 5 days]

Alt: 500 mg PO q12h for at least 5 days; Info: may be part of multi-drug regimen; refer to IDSA guidelines; give ER tab w/ food; do not cut/crush/chew ER tab

pharyngitis/tonsillitis, streptococcal

[250 mg PO q12h x10 days]

MAC primary prophylaxis, HIV pts

[500 mg PO q12h]

MAC secondary prophylaxis, HIV pts

[500 mg PO q12h]

Info: use w/ ethambutol

MAC tx, disseminated

[500 mg PO q12h]

Info: use w/ ethambutol

H. pylori infection

[500 mg PO q12h x14 days]

Info: part of multi-drug regimen; search 'H. pylori Tx' for epocrates H. pylori Tx Regimens decision tool

endocarditis prophylaxis, dental (off-label)

[500 mg PO x1]

Start: 30-60min before procedure; Info: see Infectious Disease: Endocarditis Prophylaxis, Adult table

leprosy (Hansen dz), multibacillary (off-label)

[pts who cannot take rifampin]

Dose: 500 mg PO qd x6mo; Info: not 1st-line agent; use for first 6mo of 24mo multi-drug regimen

leprosy (Hansen dz), paucibacillary (off-label)

[pts who cannot take rifampin]

Dose: 500 mg PO qd x6mo; Info: not 1st-line agent; use for first 6mo of 24mo multi-drug regimen

pertussis (off-label)

[500 mg PO q12h x7 days]

renal dosing

[see below]

CrCl <30: decr. usual dose by 50% or give IR form usual dose q24h or give ER form usual dose q48h

HD: consider decr. usual dose by 50% or giving IR form usual dose q24h or giving ER form usual dose q48h, on dialysis days admin. after dialysis; no supplement; PD: consider decr. usual dose by 50% or giving IR form usual dose q24h or giving ER form usual dose q48h; no supplement

hepatic dosing

[no adjustment]

Peds Dosing .

Dosage forms:  TAB: 250 mg, 500 mg; SUSP: 125 mg per 5 mL, 250 mg per 5 mL

infections, bacterial

[6 mo and older]

Dose: 15 mg/kg/day PO divided q12h; Max: 1000 mg/day; Info: duration varies w/ infection type, severity; not recommended for sinusitis per IDSA guidelines

pharyngitis/tonsillitis, streptococcal

[6 mo and older]

Dose: 15 mg/kg/day PO divided q12h x10 days; Max: 250 mg/dose

community-acquired pneumonia, atypical

[>3 mo]

Dose: 15 mg/kg/day PO divided q12h x7-10 days

MAC primary prophylaxis, HIV pts

[20 mo-12 yo]

Dose: 15 mg/kg/day PO divided q12h; Max: 500 mg/dose

[13 yo and older]

Dose: 500 mg PO q12h

MAC secondary prophylaxis, HIV pts

[20 mo-12 yo]

Dose: 15 mg/kg/day PO divided q12h; Max: 500 mg/dose; Info: use w/ ethambutol

[13 yo and older]

Dose: 500 mg PO q12h; Info: use w/ ethambutol

MAC tx

[20 mo-12 yo]

Dose: 15-30 mg/kg/day PO divided q12h; Max: 500 mg/dose; Info: use w/ ethambutol

[13 yo and older]

Dose: 500 mg PO q12h; Info: use w/ ethambutol

endocarditis prophylaxis, dental (off-label)

[15 mg/kg/dose PO x1]

Start: 30-60min before procedure; Info: see Infectious Disease: Endocarditis Prophylaxis, Pediatric table

H. pylori infection (off-label)

[15-24 kg]

Dose: 250 mg PO bid x10-14 days; Info: part of multi-drug regimen; search 'H. pylori Tx' for epocrates H. pylori Tx Regimens decision tool

[25-34 kg]

Dose: 500 mg PO qam and 250 mg PO qpm x10-14 days; Info: part of multi-drug regimen; search 'H. pylori Tx' for epocrates H. pylori Tx Regimens decision tool

[>35 kg]

Dose: 500 mg PO bid x10-14 days; Info: part of multi-drug regimen; search 'H. pylori Tx' for epocrates H. pylori Tx Regimens decision tool

leprosy (Hansen dz), multibacillary (off-label)

[15 yo and older, pts who cannot take rifampin]

Dose: 500 mg PO qd x6mo; Info: not 1st-line agent; use for first 6mo of 24mo multi-drug regimen

leprosy (Hansen dz), paucibacillary (off-label)

[15 yo and older, pts who cannot take rifampin]

Dose: 500 mg PO qd x6mo; Info: not 1st-line agent; use for first 6mo of 24mo multi-drug regimen

pertussis (off-label)

[1 mo and older]

Dose: 15 mg/kg/day PO divided q12h x7 days; Max: 1 g/day

renal dosing

[see below]

CrCl 10-30: decr. usual divided dose by 50%; CrCl <10: give 25% usual divided dose q24h

HD: give 25% usual divided dose q24h, on dialysis days admin. after dialysis; no supplement; PD: give 25% usual divided dose q24h; no supplement

hepatic dosing

[no adjustment]