Clarithromycin

With the medicinal substance Clarithromycin it is a macrolide antibiotic. The agent is primarily used to treat bacterial respiratory infections.

What is Clarithromycin?

Clarithromycin belongs to the group of macrolide antibiotics. It inhibits translocation and disrupts the protein synthesis of bacteria, which gives it its bacteriostatic effectiveness. A typical property of macrolides is that they have an intracellular effect and are broad spectrum antibiotics.

Clarithromycin was developed in the 1970s by the Japanese company Taisho Pharmaceutical. The antibiotic erythromycin served as a model for the preparation. The drug was finally patented in 1980. However, it was not until 1991 that it was marketed in Japan. In the same year, the product was also launched in the USA. In the further course of the approval followed all over the world. The patent protection of clarithromycin ended in Europe in 2004. After that, numerous generics containing the macrolide antibiotic were released.

Pharmacological effect

Clarithromycin has the property of slowing down the reproduction of bacteria. For this purpose, the active ingredient penetrates the bacterial cells. There it ensures that the germs can no longer produce proteins. This inhibition of bacterial growth ultimately has the effect that the human defense system suppresses the infection caused by the bacteria.

In contrast to erythromycin, clarithromycin can develop its effect against even more bacteria. It works against both air-breathing (aerobic) and non-air-breathing (anaerobic) strains of gram-negative and gram-positive bacteria. Furthermore, the antibiotic is stable against gastric acid and therefore cannot break down in the stomach. Because it is also more tissue-permeable, it enables the target locations to be reached more effectively. For this reason, clarithromycin has a better effect than erythromycin at the same dosage, despite its lower bactericidal properties.

The absorption of clarithromycin into the human intestine takes place after a short time. From there, the macrolide antibiotic gets into the blood. The drug is partly metabolized in the liver.

Clarithromycin is eliminated from the body approximately four hours after it is absorbed. 75 percent of the antibiotic gets out of the organism through the stool and 25 percent through the urine.

Medical application & use

Clarithromycin is used against infections with bacteria that are sensitive to macrolide antibiotics. The remedy can be administered against respiratory infections such as bronchitis or pneumonia, inflammation of the paranasal sinuses, throat infections, tonsillitis, wound infections, a sore throat and hair follicle infections.

Further indications are abscesses, lichen planus (impetigo) and stomach and duodenal ulcers, which are caused by the bacterium Helicobacter pylori. The agent is used together with metronidazole, amoxicillin or omeprazole.

In addition, clarithromycin is used when antibiotics that are actually more efficient cannot be administered, for example because the patient does not react well to them. This also applies to a resistance of the pathogen to the other antibiotic. This is usually the case with moderate skin infections or tonsillitis caused by streptococci.

Clarithromycin is usually administered through tablets. If necessary, the antibiotic can also be given in the form of infusions or injections if the patient has difficulty swallowing. Alternatively, clarithromycin can also be taken as juice or granules. There are also prolonged-release tablets which, when used, release the active ingredient more slowly. The patient only needs to take the drug once a day.

Clarithromycin treatment usually lasts 6 to 14 days, depending on the severity of the disease. The recommended dose is 250 milligrams of clarithromycin twice a day. However, if necessary, the dose can be doubled by the doctor. If the symptoms improve, clarithromycin must still be taken until the end of the prescribed therapy in order to counteract possible relapses.

Risks & side effects

Some patients may experience unpleasant side effects from taking clarithromycin. These mainly include temporary discoloration of the tongue, disorders of the sense of smell, taste disorders, nausea, vomiting, gastrointestinal complaints such as stomach pressure, flatulence or abdominal pain, headaches and fungal infections in the mouth.

Occasional side effects include temporary hearing loss, tinnitus, urticaria, itching, rashes, joint swelling, facial swelling, liver disorders, jaundice (jaundice), biliary obstruction and seizures.

Side effects in the gastrointestinal area are due to the fact that useful intestinal bacteria are also impaired by clarithromycin. This can lead to digestive problems.

Clarithromycin should not be used if the patient is hypersensitive to the active ingredient or to other macrolide antibiotics. In addition, it is not permitted to take the product if the potassium level is low. Otherwise there is a risk of life-threatening cardiac arrhythmias. The same applies to a slower regression in the heart.

Clarithromycin may only be taken during pregnancy with the permission of the doctor. The safety of the antibiotic in pregnancy has not yet been confirmed. During breastfeeding, the agent can pass into breast milk and thus into the baby's body, which can lead to diarrhea or intestinal inflammation.

The simultaneous intake of other macrolide antibiotics and clarithromycin leads to the fact that the active substance is inhibited in its activity. In addition, the bacteria often no longer respond to the antibiotics they have taken and become resistant to clarithromycin.