Clarithromycin

Clarithromycin (Biaxin): Uses, Dosage and Side Effects

Overview

• Time-dependent macrolide antibacterial that binds to the 50S ribosome, inhibiting peptide bonds and therefore protein formation.
• Derived from erythromycin and with greater activity.

Uses of Clarithromycin

• Useful in the management of respiratory tract infections, mild to moderate skin and soft tissue infections, and non-tubercular mycobacterial infections.
• Active against Gram-positive cocci (some Staphylococcus spp. resistant),
  Gram-positive bacilli, some Gram-negative bacilli (e.g. Pasteurella) and some spirochaetes (e.g. Helicobacter).
• Some strains of Actinomyces, Nocardia, Chlamydia, and Rickettsia are also inhibited.
• Most strains of Enterobacteriaceae (Pseudomonas, Escherichia coli, Klebsiella) are resistant.
• For the latter, used in combination with enrofloxacin and rifampin.

Dose of Clarithromycin (Biaxin) in Dogs and Cats

Dogs:

• 4–12 mg/kg i.v. infusion, p.o. q12h. Doses of 15–25 mg/kg p.o. total daily dose divided q8–12h is recommended in the treatment of leproid granuloma syndrome combined with rifampin 10–15 mg/kg p.o. q24h.
• These doses are empirical and are based on only a few reports.

Cats:

• 5–10 mg/kg i.v. infusion, p.o. q12h or 62.5 mg/cat p.o.
• These doses are empirical and are based on only a few reports.
• A variety of combination protocols have been used in the treatment of feline leprosy syndrome, e.g. combination of clarithromycin with a fluoroquinolone and either rifampin or clofazamine.

• Activity is enhanced in an alkaline pH; administer on an empty stomach.

Side Effects of Clarithromycin in Dogs and Cats

Vomiting, cholestatic hepatitis, stomatitis and glossitis may be seen.

Contraindications of Clarithromycin in Dogs and Cats

No information available

Some Notes:

1. May increase serum levels of several drugs, including methylprednisolone, theophylline, omeprazole and itraconazole.
2. The absorption of digoxin may be enhanced.