Clarithromycin for Infection: Uses, Dosage & Side Effects

About Clarithromycin

Clarithromycin is a macrolide antibiotic prescribed to treat various bacterial infections affecting different parts of the body. This medication works by stopping bacteria from multiplying, allowing the body’s immune system to eliminate the infection. Clarithromycin can be taken by adults and children and is available in multiple formulations to suit different treatment needs.

What is Clarithromycin Used For?

Clarithromycin is a type of antibiotic used to treat bacterial infections such as respiratory infections, ear infections, and skin infections. The medication is particularly valuable for patients who are allergic to penicillin, as clarithromycin offers an alternative treatment option.

Common conditions treated with clarithromycin include:

• Bacterial throat infections (pharyngitis and tonsillitis)
• Sinus infections (acute maxillary sinusitis)
• Ear infections (acute otitis media)
• Bronchitis and acute bacterial exacerbation of chronic bronchitis
• Community-acquired pneumonia
• Uncomplicated skin and skin structure infections
• Disseminated Mycobacterium avium complex (MAC) infection

Additionally, clarithromycin is given to eliminate Helicobacter pylori, the bacterium believed to cause stomach ulcers. When prescribed for this purpose, patients will also receive other medicines to take alongside clarithromycin as part of a combination therapy.

How to Take Clarithromycin

It is crucial to follow your doctor’s instructions precisely when taking clarithromycin. Read the leaflet included in the medication package before starting treatment, as it contains detailed information about dosage and possible side effects.

Standard Dosage

The recommended dosage varies depending on the type of infection and the formulation of clarithromycin:

Adults (Standard Tablets): The recommended adult dose of clarithromycin tablets is 250 mg to 500 mg taken twice daily (every 12 hours) for 7 to 14 days, depending on the specific condition being treated. For example, pharyngitis and tonsillitis typically require 250 mg every 12 hours for 10 days, while bronchitis may require 250–500 mg every 12 hours for 7–14 days.

Adults (Extended-Release): The recommended adult dose of the extended-release form of clarithromycin is 1,000 mg (2 tablets) taken once daily for 5 to 14 days, depending on the condition being treated. For community-acquired pneumonia specifically, 1,000 mg once daily for 7 days is recommended.

Children: For children aged 6 months and older, the typical dose is 7.5 mg/kg every 12 hours for 10 days for conditions such as otitis media, pharyngitis, tonsillitis, pneumonia, and sinusitis. The maximum dose should not exceed 500 mg every 12 hours.

Administration Instructions

Standard tablets, liquid, and sachets can be taken before or after food. However, modified-release (XL) tablets should be taken after food. It is important to swallow modified-release tablets whole without chewing or breaking them, as this ensures proper drug delivery.

If you forget to take a dose, take one as soon as you remember. However, do not take two doses at the same time to make up for a forgotten one. Treatment usually lasts 5–14 days, and it is essential to keep taking the antibiotic until you finish the course, even if you feel better, unless your doctor directs otherwise. Completing the prescribed course helps prevent the infection from returning.

Who Should NOT Take Clarithromycin?

Clarithromycin is not suitable for everyone. Do not take clarithromycin if any of the following apply to you:

• You are allergic to clarithromycin or any ingredients of this medication
• You are allergic to other macrolide antibiotics, such as erythromycin or azithromycin
• You have had jaundice (yellowing of the skin or eyes) or liver problems associated with taking clarithromycin
• You have severe liver failure in addition to decreased kidney function
• You have or have had QT prolongation (an abnormal electrical activity of the heart) or an abnormal heart rhythm
• You have untreated hypokalemia (low potassium) or hypomagnesemia (low magnesium levels in the blood)
• You are taking certain medications including astemizole, cisapride, and other specified drugs

Important Medical History Considerations

Before starting clarithromycin, it is important that your doctor or pharmacist knows about your medical history. Inform your healthcare provider if any of the following apply to you:

• You are pregnant or breastfeeding
• You have any problems with the way your liver or kidneys work
• You know you have an unusual heart rhythm or prolonged QT interval
• You have ventricular arrhythmia (abnormal heart rhythms), coronary artery disease, or a history of irregular heartbeat
• You have a muscle disorder called myasthenia gravis
• You have low levels of magnesium or potassium in your blood
• You are taking any other medicines, particularly statin medicines for high cholesterol or colchicine for gout
• You are taking herbal and complementary medicines
• You have ever had an allergic reaction to a medicine

If you are taking a statin medicine for high cholesterol, your doctor may advise you to stop taking the statin while being treated with clarithromycin. Ask your doctor or pharmacist if you are unsure about your specific situation.

Common Side Effects

The most common side effects of clarithromycin are generally mild and tend to resolve after completing treatment. These include:

• Diarrhoea
• Feeling sick (nausea)
• Tummy (abdominal) discomfort
• Unusual tastes
• Tooth or tongue discolouration, and changes in the way things taste or smell (will disappear after treatment finishes)
• Sore mouth
• Headache

For tooth or tongue discolouration and taste changes, these side effects will disappear after you finish your treatment. If sore mouth becomes a problem, speak with your doctor. For headaches, ask your pharmacist to recommend a suitable painkiller.

Serious Side Effects and When to Seek Medical Attention

While clarithromycin is generally well-tolerated, some serious side effects require immediate medical attention. Check with your doctor as soon as possible if any of the following side effects occur:

• Severe abdominal or stomach cramps and pain
• Skin rash
• Symptoms of liver problems (e.g., abdominal tenderness, yellow eyes or skin, skin rash, itching, dark urine)
• Symptoms of myasthenia gravis (e.g., muscle weakness, drooping eyelid, vision changes, difficulty chewing and swallowing, trouble breathing)
• Watery and severe diarrhea, which may also be bloody

Stop taking the medication and seek immediate medical attention if any of the following occur:

• Abnormal or irregular heartbeat
• Symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; sore throat; or swelling of the face, mouth, throat, or tongue)
• Symptoms of a severe skin reaction (e.g., peeling or blistering skin)

Specific Safety Warnings

Clostridium difficile-Associated Diarrhea: As with other antibiotics, clarithromycin is associated with a serious infection called Clostridium difficile-associated diarrhea, caused by the bacteria C. difficile. This can occur as late as 2 months after your last dose of this medication. If you have loose, watery bowel movements, especially if they are green, foul-smelling, or bloody and accompanied by fever, either during or after taking clarithromycin, get medical attention as soon as possible. Nursing considerations include advising patients to report watery and bloody stools even as late as two or more months after their last antibiotic dose.

Dizziness, Confusion, and Disorientation: This medication can cause dizziness, confusion, or disorientation. Do not drive or operate machinery until you are certain that this medication does not affect your ability to perform these tasks safely.

Liver Problems: If you develop symptoms of liver problems such as loss of appetite, nausea, vomiting, yellowing of the skin or eyes, dark urine, itchy skin, or abdominal pain, contact your doctor immediately.

Myasthenia Gravis: This medication can worsen or cause symptoms of myasthenia gravis. If your symptoms worsen or you develop new symptoms such as double vision, drooping eyelids, muscle weakness, or difficulty chewing or swallowing, contact your doctor.

Drug Interactions and Precautions

Clarithromycin can interact with certain medications and substances. If you buy any medicines, check with a pharmacist that they are suitable to take with clarithromycin. This is particularly important if you are taking statin medications for cholesterol, as your doctor may advise adjusting your statin dose during clarithromycin treatment.

Clarithromycin usually doesn’t affect the contraceptive pill, but diarrhoea, vomiting, or breakthrough bleeding may reduce its effectiveness. Ask your doctor or pharmacist for advice if any of these occur.

If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking clarithromycin.

Important Reminders

Do not take clarithromycin or other antibiotics to treat a viral infection such as the common cold. Antibiotics do not kill viruses, and using them to treat viral infections can lead to the growth of resistant bacteria.

It is important to complete the prescribed course unless you are told to stop. Otherwise, your infection could come back. If you still feel unwell after completing your course of the antibiotic, make another appointment to see your doctor.

Frequently Asked Questions

Q: How long does clarithromycin take to work?

A: Clarithromycin typically begins working within a few days, but it is important to complete the full course as prescribed by your doctor, which usually lasts 5–14 days, even if you feel better.

Q: Can clarithromycin be taken with food?

A: Standard tablets, liquid, and sachets can be taken before or after food. However, modified-release (XL) tablets should be taken after food to ensure proper absorption.

Q: What should I do if I miss a dose?

A: Take a missed dose as soon as you remember. However, do not take two doses at the same time to make up for a forgotten one.

Q: Can clarithromycin treat viral infections like the common cold?

A: No, clarithromycin is an antibiotic that only treats bacterial infections. It does not work against viruses, and using antibiotics to treat viral infections can lead to antibiotic resistance.

Q: Is clarithromycin safe during pregnancy and breastfeeding?

A: Before taking clarithromycin, inform your doctor if you are pregnant or breastfeeding, as your healthcare provider needs to assess the risks and benefits for your specific situation.

Q: Can clarithromycin affect the contraceptive pill?

A: Clarithromycin usually doesn’t affect the contraceptive pill, but diarrhoea, vomiting, or breakthrough bleeding may reduce its effectiveness. Ask your doctor or pharmacist for advice if this occurs.

Q: What if I experience severe diarrhea while taking clarithromycin?

A: Severe watery or bloody diarrhea, especially if accompanied by fever, may indicate a serious infection called Clostridium difficile-associated diarrhea. Seek medical attention immediately.

Q: How should I store clarithromycin?

A: Follow the storage instructions provided in your medication leaflet. Generally, most medications should be stored at room temperature away from moisture and heat.

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medha deb

 

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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