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Serum bactericidal activity of extended-release clarithromycin against macrolide-resistant strains of Streptococcus
Gary E Stein1, Sharon Schooley
1Department of Medicine, Michigan State University, East Lansing 48824, USA.
Study Objective:
To investigate the serum bactericidal activity (SBA) over time of extended-release clarithromycin against moderately resistant strains of Streptococcus pneumoniae.
Design:
Prospective, single-dose pharmacodynamic study.
Setting:
University-affiliated research center.
Subjects:
Eleven healthy male volunteers.
Intervention:
All volunteers received a single dose of extended-release clarithromycin as two 500-mg tablets, and blood samples were obtained at 0, 2, 6, 12, and 24 hours after administration of the dose.
Measurements And Main Results:
For each blood sample, a serum bactericidal titer (SBT) was determined against S. pneumoniae strains with minimum inhibitory concentrations (MICs) of 0.5, 1.0, 2.0, 4.0, and 8.0 microg/ml to clarithromycin. The median SBT was determined for each time period. The extended-release formulation of clarithromycin exhibited SBA for 24 hours against pneumococcal strains with MICs of 0.5, 1.0, and 2.0 microg/ml. No SBA was observed against isolates with MICs of 4.0 or 8.0 microg/ml.
Conclusion:
The extended-release formulation of clarithromycin, taken once/day, will provide SBA for 24 hours against strains of S. pneumoniae with MICs of 2.0 microg/ml or less.