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Clarithromycin: where do we go from here?

J O Klein1

  • 1Boston University School of Medicine, MA.

The Pediatric Infectious Disease Journal
|December 1, 1993
PubMed
Summary
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Clarithromycin, a novel macrolide antibiotic, demonstrates broad-spectrum efficacy and good tolerability in treating various pediatric infections. It achieves high tissue concentrations and shows comparable or superior outcomes to standard treatments.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Pediatrics

Background:

  • Clarithromycin is a novel macrolide antibiotic.
  • It exhibits broad-spectrum activity against various pathogens, including Gram-positive cocci, Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma, Chlamydia, Mycobacteria, Legionella, and protozoa.
  • The drug possesses a half-life exceeding 4 hours, allowing for twice-daily dosing.

Purpose of the Study:

  • To evaluate the clinical efficacy and tolerability of clarithromycin in pediatric patients.
  • To compare clarithromycin's outcomes against standard treatments for common childhood infections.

Main Methods:

  • Randomized, multicenter clinical trials were conducted in infants and children.
  • Participants received either clarithromycin or standard antibiotic therapy.

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  • Clinical and bacteriologic outcomes were assessed.

    • Main Results:

    • Clarithromycin demonstrated clinical efficacy in treating acute otitis media, streptococcal pharyngitis, and skin structure infections.
    • Comparative trials showed equivalent clinical and bacteriologic outcomes between clarithromycin and standard drugs.
    • A higher eradication rate of group A Streptococcus from the pharynx was observed with clarithromycin compared to penicillin VK.

    Conclusions:

    • Clarithromycin is well-tolerated in children and adults, with fewer gastrointestinal side effects than erythromycin.
    • High drug concentrations are achieved in plasma, cells, and tissues, including lung and middle ear fluids.
    • Further research is needed to identify potential advantages like faster clinical improvement or shortened dosage schedules due to high tissue concentrations.