Indications:
Treatment of infections due to susceptible organisms. Such infections include:
- Lower respiratory tract infections.
- Upper respiratory tract infections.
- Skin and soft tissue infections.
- Disseminated or localized mycobacterial infections due to Mycobacterium avium or Mycobacterium intracellulare. Localized infections due to Mycobacterium chelonae, Mycobacterium fortuitum or Mycobacterium kansasii.
- Prevention of disseminated Mycobacterium avium complex infection in HIV-infected patients with CD4 lymphocyte counts less than or equal to 100/mm3.
- Combination with acid suppression agents for the eradication of H. pylori in patients with recurrence of duodenal ulcer.
Dosage:
Patients with respiratory tract/skin and soft tissue infections.
- Adults: Severe infections: can be increased to 500 mg twice daily. The duration of therapy is 5 – 14 days, excluding treatment of community acquired pneumonia and sinusitis which require 6 – 14 days.
- Mycobacterial infections: The recommended dose for adults is 500 mg b.i.d.
- Treatment of disseminated MAC infections in AIDS patients should be continued, as long as clinical and microbiological benefit is demonstrated. Clarithromycin should be used in conjunction with other antimycobacterial agents.
- Treatment of nontuberculous mycobacterial infections should continue at the discretion of the physician.
- Dosage for MAC prophylaxis: in adults: 500 mg twice daily.
Eradication of Helicobacter pylori: 500 mg twice daily in combination with other appropriate anti-microbial treatments and a proton pump inhibitor for 7 – 14 days.
Triple therapy regimen: 500 mg twice daily in conjunction with amoxicillin 1000 mg twice daily and a proton pump inhibitor in standard dose twice daily for 14 days.
Four- drug regimen: A proton pump inhibitor take twice a day together with amoxicillin 1000 mg twice daily, clarithromycin 500 mg twice daily in conjunction with tinidazole 500 mg or metronidazole 500 mg twice daily for 14 days.
10 days continuous regimen:
- A proton pump inhibitor take twice a day together with amoxicillin 1000 mg twice daily for 5 days continuous.
- A proton pump inhibitor take twice a day together with clarithromycin 500 mg twice daily and tinidazole 500 mg twice daily for 5 days.
Renal impairment: ClCr < 30 ml/min, the dosage should be reduced by one-half. Treatment should not be continued beyond 14 days.
Pediatric: The use of clarithromycin has not been studied in children less than 12 years of age.
Usage:
Clarithromycin STELLA 500 mg is administered orally and may be given without regard to meals.