Clarithromycin Dosage

Usual Adult Dose for Sinusitis

clarithromycin 500 mg orally every 12 hours for 14 days
or
clarithromycin XL tablets 1000 mg every 24 hours for 14 days

Usual Adult Dose for Helicobacter pylori Infection

500 mg orally 3 times a day for 14 days.

Usual Adult Dose for Bronchitis

clarithromycin 500 mg orally every 12 hours for 7 to 14 days
or
clarithromycin XL tablets 1000 mg orally every 24 hours for 7 days.

The initial dosages recommended for this patient with H. parainfluenzae bronchitis are:
clarithromycin 500 mg orally every 12 hours for 7 days
or
clarithromycin XL tablets 1000 mg orally every 24 hours for 7 days.

The initial dosages recommended for this patient with M. catarrhalis or S. pneumoniae bronchitis are:
clarithromycin 250 mg orally every 12 hours for 7 to 14 days
or
clarithromycin XL tablets 1000 mg orally every 24 hours for 7 days.

Usual Adult Dose for Bacterial Endocarditis Prophylaxis

500 mg orally one hour before the procedure.

Usual Adult Dose for Legionella Pneumonia

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Mycoplasma Pneumonia

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 7 to 14 days depending on the nature and severity of the infection.

Usual Adult Dose for Skin or Soft Tissue Infection

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 7 to 14 days depending on the nature and severity of the infection.

Usual Adult Dose for Nongonococcal Urethritis

250 to 500 mg orally every 12 hours. Therapy should be continued for approximately 3 to 7 days, depending on the nature and severity of the infection.

Usual Adult Dose for Mycobacterium avium-intracellulare - Prophylaxis

500 mg orally every 12 hours. Therapy is usually required indefinitely, depending on this patient's tolerance of clarithromycin and immune status.

Usual Adult Dose for Mycobacterium avium-intracellulare - Treatment

500 mg orally every 12 hours. The duration of therapy for unresectable pulmonary infiltrates is generally 18 to 24 months for the treatment of pulmonary MAI and at least 12 months after sputum conversion. The duration of therapy for disseminated MAI is generally lifelong (as long as a clinical and microbiological response is documented).

Usual Adult Dose for Toxoplasmosis

1 gram orally every 12 hours. Therapy should be continued for approximately 3 to 6 weeks, depending on the nature and severity of the infection. After completion of treatment, patients should begin life-long suppressive therapy with an appropriate agent.

Usual Adult Dose for Otitis Media

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended Therapy should be continued for approximately 10 to 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Pharyngitis

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended. Therapy should be continued for 10 days.

Usual Adult Dose for Pneumonia

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended. Therapy should be continued for 7 to 14 days for pneumococcal pneumonia and for 14 to 21 days for other infecting organisms. The duration of therapy depends on the nature and severity of the infection.

Usual Adult Dose for Upper Respiratory Tract Infection

250 to 500 mg orally every 12 hours. If Haemophilus influenzae is a suspected or documented pathogen the 500 mg dose is strongly recommended. Therapy should be continued for approximately 7 to 14 days, depending on the nature and severity of the infection.

Usual Pediatric Dose for Pneumonia

15 mg/kg/day, orally, divided every 12 hours for 10 days.

Usual Pediatric Dose for Sinusitis

15 mg/kg/day, orally, divided every 12 hours for 10 days.

Usual Pediatric Dose for Skin and Structure Infection

15 mg/kg/day, orally, divided every 12 hours for 10 days.

Usual Pediatric Dose for Bronchitis

15 mg/kg/day, orally, divided every 12 hours for 10 days.

Usual Pediatric Dose for Mycobacterium avium-intracellulare - Prophylaxis

HIV exposed or positive:

Primary prophylaxis: 7.5 mg/kg/dose (maximum: 500 mg/dose), orally, twice daily.

Secondary prophylaxis: 7.5 mg/kg/dose (maximum: 500 mg/dose), orally, twice daily, plus ethambutol, with or without rifabutin.

Usual Pediatric Dose for Mycobacterium avium-intracellulare - Treatment

Manufacturer's recommendation: 7.5 mg/kg/dose (maximum 500 mg/dose) orally twice daily. Safety of clarithromycin for MAC not studied in children under 20 months of age.

HIV exposed or positive:

7.5-15 mg/kg/dose (maximum: 500 mg/dose), orally, twice daily plus ethambutol, plus rifabutin (for severe disease).

Usual Pediatric Dose for Pertussis

Children 1 to 5 months: 15 mg/kg/day, orally, divided every 12 hours for 7 days.
Children 6 months or older: 15 mg/kg/day, orally, divided every 12 hours for 7 days (maximum: 1 g/day).

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis

15 mg/kg, orally, 30 to 60 minutes before procedure (maximum: 500 mg).

Renal Dose Adjustments

CrCl < 30 mL/min: The dose should be halved or the dosing interval doubled.

Liver Dose Adjustments

No adjustment recommended.

Dialysis

There are no data on the hemodialysis or peritoneal dialysis clearance of clarithromycin. As with other macrolides, clarithromycin serum concentrations are not expected to be appreciably affected by hemodialysis or peritoneal dialysis.

Other Comments

The higher 500 mg dosage is strongly recommended for treatment of sinusitis and Haemophilus influenzae. Usual duration of therapy is 7-14 days. The duration for treating Gonococcal infection is usually 3-7 days. Clarithromycin is used in combination with omeprazole for treating duodenal ulcers associated with H. pylori infections. Clarithromycin should be used in combination with omeprazole for 14 days followed by omeprazole alone for an additional 14 days. Mycobacterium avium infections are usually treated with a combination of 2-4 drugs for a duration of 2 years to lifetime.

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