Clarithromycin

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Clarithromycin is a macrolide antibiotic, a type of antibiotic that works by stopping the growth of bacteria.[1] It is sold under the brand name Biaxin.

Why It's Prescribed

Doctors prescribe clarithromycin to treat bacterial infections like pneumonia, bronchitis, sinus infections, and ear infections.[2] Sometimes it is prescribed in combination with other drugs to treat H. pylori, a bacteria that causes ulcers.

Labeled uses include:[3] Acute Bacterial Maxillary Sinusitis, Acute Exacerbation of Obstructive Chronic Bronchitis by M. Catarrhalis, Acute Exacerbation of Obstructive Chronic Bronchitis by Streptococcus Pneumoniae, Acute Exacerbation of Obstructive Chronic Bronchitis due to H. Flu, Acute Maxillary Haemophilus Influenzae Sinusitis, Acute Maxillary Moraxella Catarrhalis Sinusitis, Acute Maxillary Streptococcus Pneumoniae Sinusitis, Acute Otitis Media Infection, Bacterial Pneumonia, Bronchitis with Bacterial Exacerbations, Chlamydial Pneumonia, Chronic Bronchitis with Bacterial Exacerbation, Disseminated Mycobacterium Avium Complex Infection, Haemophilus Influenzae Acute Otitis Media, Haemophilus Influenzae Bronchitis, Haemophilus Influenzae Pneumonia, Lower Respiratory Infections, Moraxella Catarrhalis Acute Otitis Media, Moraxella Catarrhalis Bronchitis, Mycoplasmal Pneumonia, Peptic Ulcer due to H. Pylori, Pharyngitis due to Streptococcus Pyogenes, Pneumococcal Pneumonia, Prevention of Mycobacterium Avium Complex Disease, Skin and Skin Structure Infection, Skin and Skin Structure Streptoccous Pyogenes Infection, Staphylococcus Aureus Skin and Skin Structure Infection, Streptococcal Pneumonia, Streptococcal Tonsillitis, Streptococcus Acute Otitis Media, Streptococcus Pneumoniae Bronchitis, Upper Respiratory Infection

Additionally, it is used for the following unlabeled uses:[4] Boutonneuse Fever, Gastrointestinal Anthrax, Inhaled Anthrax, Legionnaires' Disease, Lyme Disease, Pertussis, Prevention of Bacterial Endocarditis

Form, Route, and Dosage

Clarithromycin is available as a tablet, an extended-release (long-acting) tablet, and a suspension (liquid) to take orally.[5] Clarithromycin is available as a suspension in the strengths 125mg/5ml and 250mg/5ml; as a tablet in the strengths 250mg and 500mg; and as an extended-release tablet in the strength 500mg.[6] The maximum adult dose is 1500mg per day.[7]

Risks

Side Effects

Patients taking Clarithromycin may experience side effects, such as the following:[8]

  • diarrhea
  • nausea
  • heartburn
  • abnormal taste
  • stomach pain
  • headache
  • rash
  • hives
  • itching
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing
  • hoarseness
  • blisters or red splotches on skin
  • fever
  • yellowing of the skin or eyes
  • unusual bruising or bleeding
  • pain in the upper right part of the stomach
  • lack of energy
  • flu-like symptoms
  • fast, pounding, or irregular heartbeat

Overdoses

Taking too much clarithromycin may result in an overdose. Symptoms of overdose include:[9]

  • stomach pain
  • nausea
  • vomiting
  • diarrhea

As a Pollutant

Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.[10]

In Sewage Sludge

Clarithromycin has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found clarithromycin in 45 samples (54%) in concentrations ranging from 8.68 to 617 parts per billion.[11] There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

Breakdown in the Environment

A 2004 study looked at the ability of 18 antibiotics to biodegrade in a closed bottle test.[12] The antibiotics tested were: Amoxicillin, Benzylpenicillin sodium salt, Ceftriaxone disodium, Cefuroxime sodium salt, Chlortetracycline hydrochloride, Clarithromycin, Clindamycin, Erythromycin, Gentamicin sulfate, Imipenem, Metronidazole, Monensin sodium salt, Nystatin, Ofloxacin, Sulfamethoxazole, Tetracycline, Trimethoprim naphthoate, and Vancomycin hydrochloride. The study concluded: "None of the antibiotics was readily biodegradable. Elimination in the environment by other mechanisms may happen, but will not completely mineralize the active compounds. The results of CFU determination showed that some of antibiotics have an inhibitory effect on the bacterial population. Our findings underline the need for more detailed investigating effects on antibiotics in the environment." In this study, Clarithromycin was one of the drugs that had an inhibitory effect on bacterial populations.

Articles and resources

Related SourceWatch articles

References

  1. Clarithromycin: Medline Plus Drug Information, Accessed September 2, 2010.
  2. Clarithromycin: Medline Plus Drug Information, Accessed September 2, 2010.
  3. Clarithromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  4. Clarithromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  5. Clarithromycin: Medline Plus Drug Information, Accessed September 2, 2010.
  6. Drugstore.com, Accessed September 2, 2010.
  7. Clarithromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  8. Clarithromycin: Medline Plus Drug Information, Accessed September 2, 2010.
  9. Clarithromycin: Medline Plus Drug Information, Accessed September 2, 2010.
  10. O.A.H. Jones, N. Voulvoulis, and J.N. Lester, Human Pharmaceuticals in Wastewater Treatment Processes, Environmental Science and Technology, 2005.
  11. Targeted National Sewage Sludge Survey Report, US EPA website, Accessed August 28, 2010.
  12. Radka Alexy, Tina Kümpel and Klaus Kümmerer, "Assessment of degradation of 18 antibiotics in the Closed Bottle Test", Chemosphere, November 2004.

External resources

External articles