Commonly used drugs in transplant patients:
Antibiotics
Clarithromycin (Biaxin) |
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Clarithromycin is a semisynthetic macrolide antibiotic, similar to erythromycin. It generally is bacteriostatic against Streptococcus pyogenes, S.pneumoniae, H.influenzae, and Chlamydia trachomatis. It is rapidly absorbed in the GI tract after oral administration.
Indications and dosage
Clarithromycin in a dosage of 250-500 mg q12 h for 7-10 days is used orally for the treatment of upper and lower respiratory infections, skin and skin structure infections, and otitis media caused by susceptible organisms. Clarithromycin in 1-2 g q12 h is used as a part of combination regimen (+ ethambutol 15 mg/kg daily + rifabutin 300-600 mg daily) for the treatment of disseminated infections caused by Mycobacterium avium complex (MAC). Clarithromycin in 500 mg q12 h is also used for prevention of disseminated MAC infections in immunosuppressed patients. Clarithromycin in 500 mg twice daily for 14 days is used in combination with amoxacillin 1 g twice daily and lansoprazole 30 mg twice daily (triple therapy) for the treatment of Helicobacter pylori infection and duodenal ulcer disease.
In patients with a creatinine clearance less than 30 ml/min, the dosage should be halved or the dosing interval doubled.
Adverse effects
As with oral erythromycin, the most frequent side effects are on the GI tract. These include diarrhea, nausea and abnormal taste. Serum concentrations of cisapride, theophylline, digoxin and coumadin may increase when used concurrently with clarithromycin.
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