"Clarithromycin": reviews. Clarithromycin tablets: application

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Clarithromycin is a therapeutic drug that has an antibacterial effect. The drug belongs to the group of macrolides and is used in the treatment of many types of diseases. It is prohibited to use the medicine without the supervision of a doctor - therapy should be carried out strictly after a comprehensive examination of the body and diagnosis.

Release form and composition

The drug is available in the form of prolonged-release, film-coated tablets: oval, yellow (5, 7, 10 or 14 pcs. in blisters made of polyvinyl chloride and aluminum foil, in a cardboard package 1 or 2 blisters together and instructions for use of Klacida SR ).
Composition per tablet:

• active ingredient: clarithromycin – 500 mg;
• auxiliary components of the tablet core: lactose monohydrate, magnesium stearate, anhydrous citric acid, povidone K30, stearic acid, sodium alginate, talc, sodium calcium alginate;
• film coating: titanium dioxide, sorbic acid, macrogol 8000, macrogol 400, hypromellose, quinoline yellow dye.

Composition and properties

The product is available in the form of white tablets, packaged in blisters of 10 pieces. Each blister is packed in a cardboard box with detailed instructions for use. One tablet of the drug contains 250 or 500 mg of the active ingredient - clarithromycin (this is the international nonproprietary name of the substance, or INN). But the product also includes additional components that bind the active substance and accelerate its action.

Depending on the manufacturer, the drug may have additional names - Clarithromycin Teva, Clarithromycin Zentiv, Clarithromycin Verte, etc., but in general the effect will be the same.

When an antibiotic is exposed to the body, protein synthesis in the pathogenic cell is suppressed, thereby stopping the process of its reproduction. The drug is most active against gram-positive microflora:

• streptococci;
• staphylococcus;
• listeria;
• corynebacteria.

Therefore, Clarithromycin is effective in the treatment of diseases caused by these bacteria. But no less often it is used in complex treatment:

• meningococcal infection;
• Helicobacter pylori;
• gonococcal pathology.

The drug also exhibits increased activity in the treatment of toxoplasmosis, mycoplasmosis, chlamydia, and ureaplasmosis. But the treatment for tuberculosis Clarithromycin is useless.

Special instructions for use

During the period of treatment with Klacid, it is recommended to refrain from performing any activities that require concentration, including driving any types of vehicles. When prescribing the drug to patients diagnosed with diabetes mellitus, it should be taken into account that the suspension contains sucrose.

Also, when treating with this antibacterial agent, the following special instructions should be taken into account:

in patients suffering from myasthenia gravis, when exposed to a substance such as clarithromycin, symptoms may increase, including pathological fatigue; patients suffering from severe heart failure can receive treatment with Klacid only with constant ECG monitoring; in case of chronic liver failure, Klacid can be used with caution, and it is necessary to regularly monitor blood serum enzymes; if the patient is simultaneously taking other medications that are metabolized by the liver, Klacid is prescribed with caution; therapy with this antibacterial agent can lead to changes in intestinal microflora and the development of pseudomembranous colitis; long-term use of the drug leads to the formation of large colonies of bacteria and fungi that are not sensitive to a substance such as clarithromycin; the drug is incompatible with alcohol, since the latter increases the level of toxicity of clarithromycin, significantly increasing the risk of side effects.

Long-term use of Klacid can provoke a violation of the intestinal microflora

Special instructions and analogues

The use of Clarithromycin in the treatment of bacterial diseases has the possibility of developing superinfection due to the destruction of intestinal microflora. If diarrhea develops while taking an antibiotic, pseudomembranous colitis may develop. Therefore, it is necessary to begin to deal with such symptoms in a timely manner.

If you are using antibiotics, you must notify your doctor before starting to take Clarithromycin. Otherwise, serious complications are possible.

Analogues of Clarithromycin are:

• Ecositrin;
• Fromilidine;
• Clubax;
• Fromilid-uno;
• Klacid.

These drugs contain a lower concentration of the active substance, which is the main difference. The cost of the product is not always cheaper than Clarithromycin. But before replacing it with an analogue, you need to find out from a specialist how much better another drug will be.

Preparing the suspension correctly

To properly prepare the suspension, you need to add the required amount of water to the level of the mark into the bottle with granules, and then shake it well. If necessary, it is allowed to add additionally the required amount of water, but not higher than the level indicated on the bottle. Before each dose you need a bottle of the prepared suspension.

shake vigorously.

Dosage and Application

Klacid is distributed through pharmacy chains as a suspension, and the total dosage of the drug can be 125 mg and 250 mg. In this case, you need to understand that 60 ml of this medicine contains 125 mg of the active substance clarithromycin, and 100 ml, respectively, contains 250 mg of this substance. Klacid is prescribed to children based on a variety of factors. A separate treatment regimen has been developed for children with AIDS.

Dosing for non-mycobacterial infections

The daily dose of the drug should not exceed 7.5 mg per kilogram of the child’s weight.

It is recommended to use this dose in the morning and evening until the maximum dosage of 500 mg is reached. The duration of use of the drug will be from five to ten days. The course of treatment depends entirely on the pathogen and the severity of the disease. Klacid 250 is taken regardless of meals. It is possible to take the medicine with milk.

As already mentioned, the calculation of the correct dose of the drug for children is based on the child’s weight.

Dosage of the drug taking into account morning and evening intake

For children whose weight is less than 8 kilograms, the daily dose (morning and evening) for use is calculated in the amount of 7.5 mg per kilogram of the baby’s weight.

Dosage in case of renal failure

For children with a creatinine level of less than 30 ml per minute, the dose of the drug for use is reduced by exactly 50%. In this case, the duration of treatment will be fourteen days.

Dosing of the drug for children with AIDS

For children suffering from AIDS, the daily dose of the drug (morning and evening) will be either 15 mg or 30 mg per kilogram of weight. The duration of the course of treatment will be the time period until the clinical effectiveness of the drug manifests itself.

Dosage of the drug 250 mg for children with AIDS (in teaspoons)

Pharmacological group

The active substance inhibits the biosynthesis of proteins in bacterial cells. The following microorganisms are sensitive to it:

• streptococci;
• staphylococci;
• Helicobacter pylori;
• meningococci;
• gonococci;
• Listeria monocytogenes;
• corynebacteria;
• hemophilus influenzae;
• Ducray's wand;
• Moraxella catharalis;
• whooping cough stick;
• Borrelia Burgdorfer;
• eubacteria;
• peptococci;
• propionibacteria;
• Clostridium perfringens;
• bacteroides;
• legionella pneumophila;
• chlamydia;
• ureaplasma;
• mycoplasma (mycoplasma tuberculosis);
• toxoplasma.

When taken orally, the antibiotic is well absorbed from the gastrointestinal tract; food intake somewhat slows down the rate of absorption, but does not change its bioavailability.

Passing through the liver, it is metabolized. The drug is excreted in the urine. The half-life depends on the dosage, with a dose of 250 mg it varies from 3 to 4 hours, with a dosage of 500 mg it extends to 5-7 hours.

Klacid in legends and facts

Before we move on to our drug, we need to remember penicillin. During the Soviet era, the facts of the death of patients suffering from pneumonia due to anaphylactic shock caused by this sought-after medicine were hushed up.

Why did we point out this fact to you? On numerous forums where frightened mothers talk about the practice of treating children with Klacid, you can read phrases that say that after taking it, children begin to cry loudly and for a long time. This is true. This occurs due to the fact that after taking the drug, a tolerable burning sensation begins in the throat, the intensity of which increases with increasing time interval after taking the medicine. However, it is impossible to explain to the baby what tolerance is, but the burning sensation, having reached its peak, will gradually fade away.

However, why do pediatricians prescribe Klacid to children, at a dosage of 125 mg or 250 mg, and not its analogues? The fact is that often pathogenic organisms are chlamydia and microplasma. This antibiotic can penetrate their shell and destroy them. When we are not talking about otitis media, other inflammatory processes, pneumonia, the prescription of such a medicine would be inappropriate, however, if the health and life of the baby is at stake, then the choice is obvious. In this case, it is necessary to remember that in medical practice there is a “three-day rule”.

If the prescribed drug does not lead to obvious improvements after three days, the course of treatment must be adjusted.

Regarding this drug, you also need to know one more nuance, which no instructions for use will familiarize you with. In 99% of cases, pathogenic microorganisms accumulate in the lungs and bronchi. Klacida components accumulate in the same places at a level of 88%. This means that the air we exhale also affects them. It should be noted that Klacid does not kill pathogenic organisms, but only deprives them of the opportunity to reproduce, which is quite enough for recovery. No longer posing a threat to the body, the child’s immune system does not respond to them.

Even after taking this medicine is completed, it still continues to remain in the body for a long time and perform its function, depriving pathogens of the opportunity to increase in number.

"Klabaks" and other drugs

This medication should not be used simultaneously with alkaloids, as there is a possibility of toxicosis: under the influence of Klabaks, theophylline in the plasma increases sharply and can affect the plasma concentration of some other medicinal compounds. This imposes certain restrictions on compatibility with drugs that contain cyclosporine, disopyramide, midazolam, and warfarin. A complete list is listed in the instructions for use. If the patient is taking any medications, it is necessary to notify the attending physician at the stage of choosing therapy to prevent negative effects.

If Klabaks is used simultaneously with drugs containing astemizole, it is necessary to regularly take ECG readings. When ingested simultaneously with digoxin, the drug increases the likelihood of digitalis poisoning.

How strong is Klacid and is it worth using analogues?

When purchasing Klacid in quantities of 250 mg and 125 mg at a pharmacy, they will always tell you how strong the antibiotic was prescribed to you and, perhaps, recommend some of its analogues.
What does every parent need to know in order to skillfully fend off such black incompetence of the pharmacist? In this case, the role is played not by the name of the super-strong modern antibiotic, but by the dosage in which this suspension will be taken. The pharmacist’s logic is extremely simple: if the dosage of one antibiotic is four times higher than the dosage of another, then in the first case you are dealing with a very strong drug. What do you really need to know about our drug? Klacid suspension is extremely resistant to gastric microflora. It is completely absorbed into the bloodstream and does its job responsibly. This suggests that it can be prescribed in more loyal doses, which will not decompose in the stomach for the most part and irritate its lining.

Always discuss any confusion regarding the prescribed medication exclusively with your doctor and, if possible, look for analogues. If we are already talking about substitutes, let's look at what analogues are possible in relation to our drug. So, Klacid can successfully replace Clarithromycin. This medicine is as close as possible in its medicinal qualities to the drug being discussed today. In general, there are about ten substitutes for this medicine. However, only your pediatrician should determine the completeness of interchangeability.

Klacid in dermatovenereology

At the same time, Clarithromycin is one of the most popular antibacterial drugs in dermatovenerology. It is effective against most soft tissue and skin infections, including furunculosis, folliculitis, erysipelas (erysipelas associated with staphylococcal infection), and skin infections that develop after cat scratches (felinosis). In addition, Klacid tablets are one of the drugs of choice for the treatment of two very “popular” sexually transmitted infections: chlamydia and mycoplasmosis.

By the way, many venereologists, when prescribing a course of treatment for these two diseases, intimidate patients with the extremely low effectiveness of treatment. They write huge prescriptions containing up to a dozen different drugs, recommend massages, baths, poultices and lotions, claiming that only in combination can the disease be dealt with. But in reality, everything is not quite like that.

Tales about the difficult treatment of chlamydia and mycoplasmosis, full of hardships and difficulties, are associated with the fact that both chlamydia and mycoplasma are intracellular bacteria that are insensitive to most antibiotics. If you choose the right drug and start therapy with macrolides (for example, Klacid or Sumamed), then there will be no problems if the correct dosages and duration of treatment are observed. Macrolides penetrate perfectly into cells and destroy bacteria.

Side effects

In this conversation, side effects were mentioned that belong to a whole group of these antibiotics. Now let's take a closer look at the undesirable effects that Klacid 250 causes. In terms of safety, the Klacid suspension is identical to tablets. However, in some cases the following side effects occur:

• stomatitis;
• glossitis;
• oral thrush;
• change in tongue color;
• change in tooth color;
• increased activity of liver enzymes;
• hepatitis without or with jaundice;
• pancreatitis;
• severe liver dysfunction (in rare cases, deaths have been reported).

• dizziness;
• insomnia;
• groundless anxiety;
• nightmares;
• noise in ears;
• confusion;
• disorientation;
• psychosis;
• hallucinations;
• depersonalization.

• violations of charm;
• hearing loss or impairment;
• perversion of taste.

• thrombocytopenia;
• rare cases of leukopenia.

• hypoglycemia;
• increase in serum creatinine levels.

• rash;
• hives;
• anaphylaxis;
• Lyell's syndrome;
• Stevens-Johnson syndrome.

What to fear?

The side effects indicated in the instructions for use of Clarithromycin are confirmed by reviews of people who have used this antibiotic. Since the drug is accessible, proven and effective, it is prescribed quite often, so there are many responses about its use. It is known that the drug can cause tinnitus, and some patients noted that this side effect bothered them for some time after completing therapy. It is known that in isolated cases the tablets can cause deafness. The phenomenon is reversible, hearing is restored as soon as the medication is discontinued.

Quite rarely, thrombocytopenia and erythema maligna occur during a drug course. There is a risk of skin rashes and isolated itchy areas. The medication may cause an anaphylactoid response in the body.

FDA studies suggest that additional side effects of Clarithromycin are associated with prolonged treatment. The use of antibiotics for a long time against the background of heart and vascular diseases probably creates fatal risks and increases the likelihood of complications. The fact that the drug is unsafe is confirmed by observations of patients suffering from cardiac ischemia over a period of one decade. It was revealed that among people in this group who used Clarithromycin for two weeks or more, for an inexplicable reason, the percentage of deaths increases. It is likely that the increased risk of mortality continues for one year after stopping the antibiotic.

Contraindications

All macrolides, including Klacid, are contraindicated for use in the following cases:

• a history of episodes of allergic reactions or hypersensitivity to any macrolide;
• age up to 12 years;
• severe kidney and/or liver disease;
• hereditary pathology, manifested by insufficiency of lactose production, galactose and glucose absorption;
• taking ergot-based medications.

Only a specialist can assess the potential risk and desired benefits. Only a doctor can suspect the occurrence of side effects in time and prevent their progression.

Indications and contraindications

The instructions for use of Clarithromycin 500 mg tablets state that the drug is used for infections caused by microorganisms sensitive to the active substance. Therefore, before treatment, it is necessary to culture the microflora and analyze its sensitivity to the antibiotic. In practice, this does not always happen; thanks to the wide spectrum of action of the macrolide, the infections listed in the instructions are successfully cured.

Indications for antibiotic use:

• diseases of the upper respiratory tract: pharyngitis, tonsillitis.
• sinusitis.
• bronchitis, pneumonia.
• soft tissue infections.
• odontogenic infections.
• stomach ulcer (if it is necessary to destroy Helicobacter pylori).
• infections caused by certain types of mycobacteria.

Contraindications to the use of the drug are hypersensitivity to macrolides, severe liver and kidney diseases.

The combined use of antibiotics with drugs from the statin group and some antipsychotic drugs is prohibited. Clarithromycin changes the pharmacokinetics of antiarrhythmic and hypoglycemic drugs, omeprazole, sildenafil, itraconazole, therefore, when taken simultaneously with these drugs, careful medical monitoring of patients is necessary.

Macrolide is not prescribed to pregnant women; due to the penetration of the drug into breast milk, the mother of the child is transferred to artificial feeding during treatment. The antibiotic in tablet form is not used to treat children under 12 years of age; younger children are given an oral suspension of Clarithromycin.

Advantages of Klacid as an original drug

The pharmaceutical market offers a huge variety of tablets at different prices, in different dosages and dosage forms. Most drugs are generic analogues, and only some tablets and suspensions are original drugs. The price of generic drugs is always lower, but for the best results, quick and effective recovery, it is recommended to take original drugs.

What is the difference between original tablets and generic analogues? An original drug is a drug that was synthesized first in its pharmaceutical form. For example, for clarithromycin the original is Klacid. That is, Abbot drug production specialists many years ago first synthesized the drug substance clarithromycin. After all preclinical and clinical trials of clarithromycin, including on human volunteers; Having received permission and a license, the Abbott pharmaceutical concern began to produce tablets, suspension and powder Klacid containing the medicinal substance clarithromycin.

The original drug has a certain period of patent protection, during which time no other pharmaceutical company has the right to produce drugs containing the same chemical. In the case of the drug Klacid, until the protection period expired, no pharmaceutical company other than the Abbott plant had the right to produce clarithromycin. When the patent protection expires, any pharmaceutical plant can produce and release a generic product (another clarithromycin drug, not Klacid), and supply it to the pharmacy market, without special tests and trials. That is, the quality of generics often leaves much to be desired. When buying generic analogues of Klacid, which are cheaper, you can only rely on the integrity of the manufacturer.

Indications for use of Clarithromycin for children

Among the main factors for using an antibacterial agent are the following:

• lesions of the lower respiratory tract , most often with various types of bronchitis and pneumonia;
• infectious lesions of the upper respiratory tract , usually with purulent tonsillitis, pharyngitis and sinusitis of various origins;
• uncomplicated infectious diseases of soft tissues of the skin and mucous membranes;
• duodenal ulcer caused by the Helicobacter bacterium.

Clarithromycin is most effective against pathogenic pathogens of tuberculosis. Due to its increased effectiveness, the antibacterial drug is also recommended to be used to suppress the chronic type of tuberculosis.

Many developed countries use Clarithromycin in government programs for the treatment and rehabilitation of patients with tuberculosis in childhood and adulthood. According to available data, the antibiotic increases the effectiveness of therapy by up to 15%.

Contraindications for use

You should not use an antibacterial agent if you have the following problems:

• severe kidney and liver diseases , including hepatitis;
• tablets can be used only when the patient reaches a weight of 33 kg or 12 years;
• porphyria and persistent intestinal disorders;
• presence of glucose malabsorption syndrome;
• intolerance to the active substance or other macrolides;
• intolerance to any of the components of Clarithromycin.

Attention! If you ignore these requirements specified in the instructions for use, the child may face unpleasant consequences in the form of gastrointestinal problems, exacerbation of kidney and liver diseases, anaphylactic shock, rash and itching.

Regimen and dosage of 250 and 500 mg for tuberculosis in children under 12 years of age

Clarithromycin is usually not taken by patients under 12 years of age . Despite its good effectiveness, in some cases the antibiotic provokes allergic reactions and problems with the gastrointestinal tract. But thanks to the purer formula, such problems do not arise as often as with first and second generation drugs.

Photo 1. The drug Clarithromycin, 14 tablets of 500 mg from.

From the age of twelve, it is recommended to take 250 mg of the active substance twice a day every 12 hours . For more acute manifestations of pathologies, the treatment regimen involves taking 500 mg of Clarithromycin daily for 7-14 days . For tuberculosis, only the attending physician can determine the exact duration of treatment.

Up to 12 years of age, the antibacterial drug is recommended, if necessary, to be taken in the form of a suspension. The dosage in this case is 15 mg of the active substance per kilogram. A single dose is taken morning and evening.

Reference! After taking Clarithromycin, it is recommended to drink a small amount of liquid to better absorb the active substance. The duration of therapy is selected individually.

Meet Klacid

Many parents are familiar with a drug called “Erythromycin”.
In their time, drug analogues were not as common as they are today. Indirectly, in our time, Klacid acts as an analogue of this medicinal product as a suspension in dosages of 125 mg and 250 mg, which is an antibacterial modern drug that belongs to the group of so-called macrolides. Without going deep into chemistry, let’s say that macrolides are among the least toxic antibiotics, and therefore the safest. Is this really true in relation to the medicine we are considering. At one time, treatment with Erythromycin was difficult in that it had a very bitter taste, and in order to achieve the necessary therapeutic effect it had to be taken at least four times throughout the day and for at least five days.

Pediatricians prescribe Klacid 250 mg due to the absence of negative aspects, which can be expressed by a variety of side effects, and also due to the presence of anti-inflammatory components in it. However, there are points that say exactly the opposite, and the instructions for use are silent about them. After reading this sentence, do not panic or throw away this drug. It is necessary to sort everything out and understand why Klacid is so often prescribed to children, are there any analogues and what is its danger or superiority?

Interaction with other drugs

While taking the drug, inhibition of the activity of the CYP3A4 isoenzyme is observed, as a result of which, when clarithromycin is combined with astemizole, the metabolic rate of the latter slows down. This leads to a prolongation of the QT interval and the risk of developing torsade de pointes (TdP).

Parallel administration of a macrolide with statins, which are metabolized with the participation of CYP3A (simvastatin, lovastatin), leads to an increase in their serum concentration, which is fraught with the development of myopathy, including rhabdomyolysis. Therefore, during antibiotic therapy, these statins should be interrupted.

Other lipid-lowering drugs should be taken with caution. During antibiotic treatment, it is recommended to take statins that are not metabolized by the CYP3A isoenzyme, for example, fluvastatin. Lipid-lowering drugs should be taken in minimally effective dosages. The patient should be informed about the clinical manifestations of myopathy and, if it occurs, seek medical help. When administered in parallel with atorvastatin, its content in the bloodstream increases, as a result of which the likelihood of developing myopathy also increases.

CYP3A inducers accelerate the metabolism of clarithromycin, which may reduce the effectiveness of the antibiotic. It is also necessary to monitor the content of the inducer in plasma, since its concentration may increase due to inhibition of CYP3A by the macrolide.

When combined with rifabutin, its content in plasma increases and the likelihood of developing uveitis increases, while the level of clarithromycin in the body decreases.

When taken simultaneously with a macrolide, the concentration of anticonvulsants in plasma, such as phenytoin, carbamazepine, and valproic acid, may increase.

Drugs that are strong inducers of isoenzymes of the cytochrome P450 system can accelerate the metabolism of the antibiotic, resulting in a decrease in its concentration in the body and a weakening of the therapeutic effect of it and, in parallel, an increase in the content of its microbiologically active metabolite 14-OH-clarithromycin. But clarithromycin and its metabolite are active against various microorganisms. Therefore, the therapeutic effect when taking a macrolide simultaneously with efavirenz, nevirapine, rifampicin, rifabutin and rifapentine may be reduced.

When taken in parallel with etravirine, the content of clarithromycin decreases and the level of 14-OH-clarithromycin increases, which has low activity against MAC infections, so when such a combination is unavoidable for their treatment, alternative therapy should be used.

With simultaneous administration of ritonavir at a dosage of 200 mg every 8 hours and clarithromycin at a dosage of 500 mg every 12 hours, suppression of macrolide metabolism was observed, as a result of which the concentration of clarithromycin increased and 14-OH-clarithromycin decreased. It is not recommended to take ritonavir in a daily dosage of more than 1 g during antibiotic therapy.

Clarithromycin, atazanavir, and saquinavir are substrates and inhibitors of CYP3A, which determines their bidirectional interaction. When combining saquinavir with ritonavir, the possibility of an effect of ritonavir on clarithromycin should be considered.

Macrolide may slightly reduce the bioavailability of zidovudine.

Colchicine is a CYP3A and P-gp substrate, while clarithromycin is a CYP3A and P-gp inhibitor. Taking these drugs together may increase the effects of colchicine and cause overdose and death, especially in older adults and patients with kidney failure. Therefore, it is prohibited to treat with colchicine while taking an antibiotic.

With simultaneous administration of clarithromycin and midazolam, the AUC of the latter increases: with oral administration by 7 times, with intravenous administration by 2.7 times. Therefore, against the background of antibiotic therapy, midazolam should not be taken orally; when administered intravenously, one should constantly monitor one’s well-being and, if necessary, adjust the treatment regimen. The same precautions should be taken with benzodiazepines that are metabolized by CYP3A.

When prescribed while taking an antibiotic, triazolam can provoke undesirable reactions from the central nervous system, for example, drowsiness and impaired consciousness.

When prescribed with warfarin, there may be an increase in the anticoagulant effect of it and an increased likelihood of bleeding.

It is assumed that digoxin is a substrate of P-glycoprotein, and since clarithromycin is its inhibitor, there is a possibility of increased levels of cardiac glycoside in the blood and the possibility of glycoside intoxication.

When administered simultaneously with quinidine and disopyramide, atrial fibrillation may develop. With this combination of drugs, you should regularly do EGC and donate blood to determine their concentration in the body.

Taking it together with disopyramide may cause a decrease in blood sugar levels. This may be due to an increase in disopyramide levels in the blood due to the suppression of its metabolism in the liver by clarithromycin.

Clarithromycin and itraconazole are both CYP3A substrates and inhibitors and may therefore increase plasma concentrations of each other.

The antibiotic can reduce the clearance of methylprednisolone; when a macrolide is prescribed with prednisone, it can cause the development of acute mania and psychosis.

Clarithromycin can significantly increase the level of omeprazole and theophylline. When taken simultaneously with lansoprazole, darkening and inflammation of the tongue and stomatitis may occur.

When taking sertraline during antibiotic therapy, serotonin syndrome can theoretically occur.

When clarithromycin is combined with terfenadine or cisapride, the metabolic rate of the latter may slow down, which can cause a prolongation of the QT interval and the development of ventricular arrhythmias.

Tolterodine is metabolized by CYP2D6, but in some people this enzyme is missing and is replaced by CYP3A. In such patients, inhibition of CYP3A leads to an increase in tolterodine levels in the body, so their dosage should be reduced when administered with clarithromycin.

Simultaneous administration of a macrolide with insulin or oral hypoglycemic agents may cause a drop in blood sugar levels.

Clarithromycin can increase the toxicity of fluoxetine, enhance the undesirable effects of ergotamine and dihydroergotamine (vascular spasms, ischemia of the arms and legs, as well as other tissues, including the central nervous system), and cyclosporine.

When concomitantly prescribing clarithromycin with ototoxic drugs, especially aminoglycosides, caution should be exercised and the functioning of the vestibular and auditory systems should be monitored both during treatment and after its completion.

All PDE inhibitors are at least partially metabolized by CYP3A, so the dosage of sildenafil, tadalafil and vardenafil should be reduced while taking antibiotics.

When clarithromycin is combined with calcium channel blockers that are metabolized by the CYP3A4 isoenzyme, a drop in blood pressure may occur. With this prescription, there may be an increase in the concentration of both drugs at the same time.

Prescription of verapamil while taking the antibiotic can provoke arterial hypotension, lactic acidosis and bradyarrhythmia.

Instructions for use

Klacid tablets are taken orally regardless of meals. Dosage for adults is 250 mg twice a day, in severe cases take 500 mg twice a day. The maximum daily dose of the drug is 2000 mg (for adults). The course of treatment lasts from 5 to 14 days. The drug is taken as prescribed by a doctor.

It is very important to take your pills at the same time every day. The interval between doses is 12 hours, it should not be shortened or extended. Patients with kidney disease and the elderly are recommended to take lower doses - 125 mg (half a tablet) twice a day

In some cases, it is permissible to take the medicine once instead of twice

Patients with kidney disease and the elderly are recommended to take lower doses - 125 mg (half a tablet) twice a day. In some cases, it is acceptable to take the medicine once instead of twice.

The tablets should be taken with water or warm tea. They should not be mixed with milk, juices or coffee, as this may interfere with the absorption of the drug. The duration of treatment cannot be less than five days to avoid the development of bacterial resistance to clarithromycin.

How to use it correctly?

For patients over twelve years of age, it is recommended to use Clarithromycin 250 mg every 12 hours. If the infection is severe, the dose is doubled. Course duration is 6-14 days. The drug is used regardless of meals, since food does not adjust the bioavailability of the active compound.

For odontogenic infections, it is recommended to take 250 mg twice a day for five consecutive days with twelve-hour breaks. For mycobacterial invasion, first use the product 0.5 g twice a day for 3-4 weeks. If the program does not give the desired result, the dose may be doubled.

In case of disseminated MAC infection against the background of AIDS, the duration of the course is as long as the drug shows effectiveness, confirmed by tests. It is allowed to combine the drug and some other antibiotics.

When the drug is prescribed and its mechanism of action

Clarithromycin, the main active ingredient of Klacida, is an antibiotic with a bactericidal effect. It disrupts the synthesis of intracellular proteins of the microbial cell, thereby causing its death. An important difference between macrolides in general and clarithromycin in particular is their high effectiveness against intracellular parasites. Many modern microbial agents are capable of forming intracellular forms, which ensure their long-term circulation in the human body and, accordingly, a long course of the disease. To destroy the intracellular form of the microbial agent, only certain antibacterial agents are needed.

This antibacterial agent has a whole range of benefits. Among them, the most significant ones should be emphasized:

• relatively high bioavailability, that is, the active substance and metabolite penetrate well into all tissues and organs;
• Not only its main active ingredient, but also all metabolites have antimicrobial activity;
• the drug is excreted approximately equally in urine and feces, which makes it possible to use it in patients with chronic kidney disease;
• gastric juice does not have a negative effect on absorption, but rather promotes this process and potentiates the effect of active metabolites.

Mechanism of action of the antibiotic

The mechanism of action of this antibacterial composition is reflected in the instructions; it includes bactericidal and bacteriostatic types of effects.

Clarithromycin actively fights such groups of pathogenic microorganisms as:

• intracellular: ureaplasma, chlamydia, legionella, mycoplasma;
• gram-negative: hamophilis influenza Helicobacter, Bordetella, Neisseria, Moraxella, Borellia;
• anaerobic: peptococci, eubacteria, clostridia;
• gram-positive: staphylococci, listeria, streptococci;
• mycobacteria, tocoplasma.

Pharmacological action and pharmacokinetics are reflected in the instructions that are attached to each package of the drug.

After the active substance penetrates the human body, its absorption processes rapidly develop. If the patient takes food at the same time as taking the tablet or capsule, absorption will be somewhat slower, but will not have a significant effect on the bioavailability of the substance.

Almost 90% of the antibiotic binds to plasma proteins. A one-time dose of Clarithromycin provokes two moments when the maximum concentration of the active substance is observed. The first occurs 2-3 hours after oral administration of the tablets, the second occurs when the substance reaches the gallbladder area. There, the medicine is concentrated, then goes down to the intestines, where it is absorbed.

The half-life of the drug outside the body ranges from 3 to 6 hours; such a significant difference is associated with the excretion of the active substance and the resulting metabolites.

Clarithromycin has the ability to accumulate in lung tissue, skin, and soft tissues. The concentration of the substance is at a therapeutic level.

The drug is eliminated from the body through the bladder and intestines.

Use in childhood

The presented drug is prescribed to children in a number of the following cases:

• This medicine is recommended by pediatricians for childhood infections (for example, in the case of whooping cough and scarlet fever).
• In acute and chronic processes affecting the respiratory canals, for example, in the case of bronchitis, pneumonia, lung abscess, and so on.
• "Klacid" is effective for sore throat, pharyngitis and laryngitis.
• The drug demonstrates high effectiveness in the treatment of otolaryngological diseases, for example, otitis media, sinusitis, and sinusitis.
• It is the drug of choice for the treatment of chlamydial and mycoplasma infections. It is also effective in the presence of gonorrheal or chlamydial conjunctivitis.
• This remedy is part of a complex treatment prescribed for ulcerative pathology of the digestive system.
• This medicine is also prescribed for wounds, bites, and also in case of burns. The drug perfectly helps the body fight infectious diseases of the skin, for example, erysipelas.

The daily dosage of Klacida for children cannot exceed 500 milligrams. The volume of medication is calculated based on the child’s body weight. As a rule, the daily dosage is calculated as follows: 15 milligrams of medication per kilogram of weight. The resulting amount of product is divided into two doses, with a break of twelve hours. The duration of therapy directly depends on the severity of the pathology, concomitant diseases and the general condition of the child. As a rule, the medicine is prescribed for five to ten days.

The drug "Clarithromycin": indications for use

As mentioned, this medicine is widely used to treat bacterial diseases. So in what cases do doctors prescribe the drug Clarithromycin, the use of which is widespread? The indications are as follows:

• Infectious diseases of the upper respiratory tract, including sinusitis, laryngitis, tonsillitis and pharyngitis.
• Diseases of the lower respiratory tract. In particular, the drug is effective for pneumonia (including the atypical form), acute bronchitis and chronic inflammation of the bronchi during an exacerbation.
• Bacterial infections of soft tissues and skin, including wound infection, folliculitis, impetigo, furunculosis.
• Indications for use are inflammatory diseases of the stomach and duodenum. By the way, this drug in combination with other drugs is used for Helicobacter pylori activity.
• In otolaryngology, the medicine can be used to treat otitis media.
• Indications include some sexually transmitted infections, including chlamydia.

Use in adults

Although Klacid 500 is not a first-line therapy in the treatment of ear, nose and throat diseases, it is often used at the very beginning of treatment of the disease, or as a second-line therapy. According to clinical recommendations, amoxicillin is the antibiotic to start treating ENT diseases, but it is preferable to start therapy with clarithromycin if:

• The patient has taken Amoxicillin or other beta-lactam antibiotics within the previous 30 days;
• Are allergic to penicillins (beta-lactam antibacterial drugs);
• The disease is caused presumably by atypical flora.

If the patient took amoxicillin for the treatment of any disease in the previous month, it is advisable not to prescribe amoxicillin for the treatment of subsequent diseases, since the bacteria develop resistance and the treatment will not be as effective. Macrolide antibiotics (azithromycin, clarithromycin, josamycin) and fluoroquinolones (levofloxacin, ofloxacin) are considered the second line of therapy. According to the recommendations, for the treatment of sinusitis, it is advisable to use clarithromycin (Klacid) rather than azithromycin, since many microorganisms have developed drug resistance to azithromycin.

Atypical microorganisms include chlamydia, mycoplasma, and ureaplasma. You can suspect sinusitis caused by atypical flora based on a number of signs:

• Long, sluggish course with erased symptoms.
• Copious transparent, mucous discharge, without admixture of pus.
• Severe swelling of the mucous membrane of the nose and sinuses. Swelling of the mucous membrane can be detected by endoscopic examination or computed tomography of the paranasal sinuses.
• Lack of effect from treatment with beta-lactam antibiotics (amoxicillin, ceftriaxone and others).

When else should you take Klacid 500 for sinusitis? If there is no effect from treatment with first-line drugs (Amoxicillin, Ceftriaxone, Amoxicillin clavulanate) for 3 days, symptoms persist or there are no changes in the x-ray of the paranasal sinuses. In this case, the first antibiotic should be replaced with Klacid 500 (clarithromycin). According to the instructions for use, the average dose for an adult is 500 mg 2 times a day. It is advisable to take the tablets in the middle of a meal with a small amount of water. The average course of treatment is 5-7 days. Since doses of all antibiotics are calculated based on weight, the average weight of an adult is taken to be 70 kilograms. If a sick person weighs significantly more (more than 100 kg) or significantly less (50 kg or less), the dose should be calculated using the formula: 7.5 mg per kilogram of weight divided into 2 doses.

Features of the drug

Clarithromycin suspension for children is an effective compound that has an inhibitory effect on harmful microorganisms that cause diseases of the upper respiratory tract. When a patient takes an antibiotic, bacteria cannot multiply, so the symptoms quickly resolve.

Clarithromycin is an antimicrobial substance from the macrolide group. Clarithromycin suspension is an antibiotic with extensive effectiveness, due to which it shows good results in various diseases. The drug "Klatsid" (trade name of clarithromycin suspension) contains auxiliary components. This makes the therapeutic course even more effective. However, if the child is known to be intolerant to any substance used in the pharmaceutical industry, parents should carefully study the instructions for use of clarithromycin suspension for children to see if there is a potentially dangerous component on the list. If you are known to be allergic to any medication, you must inform your doctor about this at the time of writing the prescription.

Contraindications and side effects

Clarithromycin is contraindicated in case of porphyria, hypersensitivity to macrolide antibiotics, as well as during pregnancy and breastfeeding. It is unacceptable to use it for children under three years of age. There are also restrictions on simultaneous use with a number of drugs (indicated in the instructions).

The list of side effects of the drug is extremely extensive. Most often, nausea, vomiting, abdominal pain, changes in taste perception, and headaches occur. The parameters of the biochemical blood test may change, in which case increased activity of liver enzymes is observed.

• candidiasis of the oral cavity or genital organs;
• intestinal dysbiosis;
• hypoglycemia;
• insomnia, hallucinations;
• hematopoietic disorder;
• cramps, muscle pain, loss of coordination;
• hearing loss (reversible);
• ventricular tachycardia.

The incidence of these effects is relatively small, but the possibility of their development should be taken into account. Such reactions are dangerous to health, so if they occur, you should consult a doctor so that a specialist can decide whether it makes sense to complete the course of treatment or whether clarithromycin should be replaced with another drug.

Cost and analogues of antibiotics

Clarithromycin is the main analogue of Klacid

The average cost of a Klacid package containing 10 tablets with a concentration of the active component of 250 mg is about 800 rubles. For a 125 ml bottle of suspension in pharmacies across the country you will have to pay about 380-400 rubles. If for some reason it is not possible to take this antibiotic (contraindications, unavailable in pharmacies), the doctor may recommend replacing it with one of its analogues. It should be borne in mind that some antibiotic analogues are cheaper, while others are more expensive.

Analogue name	Average cost per package/bottle, rubles	Active ingredient	Age restrictions
Clarithromycin	120 (concentration 250 mg)	Clarithromycin	From 6 months (suspension)
Ecositrin	230-370 (concentration 250 mg)	From 12 years old
Clubax	250 (5 tablets 500 mg)	From 12 years old
Azicine	220-280	Azithromycin	From 3 years
Rovamycin	1000 (1.5 million IU)	Spiramycin	From 3 years (injections - from 18 years)

Useful materials:

1. Syrup and cough drops "Gedelix" for children under one year of age and older - instructions for use of the drug and analogues
2. Children's "Motilium": instructions for use of suspension and tablets for newborns and children over one year old, analogues
3. Albucid eye drops: instructions for use for newborns and older children
4. Antiviral drugs for children - effective and inexpensive drugs for children aged 1-3 years
5. "Amoxicillin": instructions for use of suspension and tablets for children with dosage calculation

The most severe side effects of macrolides

Based on the fact that Klacid 250 belongs to this group of antibiotics, its side effects can be extremely pronounced.
You should not refuse to take this drug, since every medicine has them, expressed to one degree or another. The absence of side effects indicates that the drug cannot be called a medicinal drug. Please note that this expression applies not only to antibiotics, but even to phytotherapeutic drugs and homeopathy. Do not be afraid of the side effects of this medicine. You need to know how to act if they occur. In this case, we will tell you what to do in the case of those who are most “dangerous” in the eyes of parents.

Irritation of the intestines and stomach

It manifests itself in the form of pain in the stomach, nausea, and extremely rarely, vomiting. The only way out of this situation is to change the antibiotic to an analogue. As a rule, it will not be stronger in effect, but in a much lower dosage, which will help get rid of irritation of the gastrointestinal tract.

Pain in the liver area, jaundice (medicinal)

Pain in the liver may be present due to the fact that it takes an active part in removing all components of the drug from the child’s body. Irritation of the biliary tract is also possible, which can be accompanied by severe pain and ultimately jaundice. The latter is dangerous, the first is simply painful. In this situation, you must stop taking Klacid, regardless of the release form of 125 mg and 250 mg, and immediately seek advice.

Temporary hearing loss, headaches

At the beginning of the article, you learned in what cases pediatricians prescribe Klacid 250 to children.

If it treats acute otitis, hearing loss is possible, but temporarily.

The thing is that its components have a strong effect on the human nervous system, and also provoke powerful releases of adrenaline into the blood. The situation is further aggravated by the fact that this medicine is always concentrated in areas of inflammation and exerts its side effects precisely in these areas of the body.

The way out of this situation will be the same - stop taking the medication and immediately consult a pediatrician for advice.

Allergic reactions

In this case, urticaria may appear. In the worst case scenario, there is angioedema, which will tend to infinity as you take the medicine. In this case, you also need to immediately stop giving the child Klacid 250 and contact your doctor. Based on the fact that this medicine significantly slows down the removal of histamines from the bloodstream, doses of antiallergic medications should be prescribed and monitored exclusively by a pediatrician.

Dysbacteriosis

Despite the fact that many doctors assure their patients that Klacid does not in any way affect the intestinal microflora, ignore this assurance and know your own.

Any antibiotic, regardless of the group, destroys bacteria that take part in the digestion process.

Therefore, use Linex, or consult with your pediatrician regarding its use, and in what doses.

Clarithromycin® analogues

Binoclair®

Active against gram+ (staphylococci, streptococci), gram- (haemophilus influenzae, hemophilus, gonococcus, Legionella pneumophila, Campylobacter jeuni) foreign agents, as well as anaerobes (bacteroides, clostridia, peptostreptococci). Rapidly absorbed from the gastrointestinal tract. Bioavailability reaches 50 percent. The half-life is about 4 hours.

Clubax®

It is a semi-synthetic macrolide of the latest generation. Klabaks is effective in the treatment of tonsillitis, pneumonia, and furunculosis. The antibiotic is taken 250 mg twice a day; for severe infections, the dosage is doubled. The course of treatment is from 1 to 2 weeks.

Klabax OD®

The main active ingredient is clarithromycin. The drug is effective for infections of the respiratory tract, ENT organs, skin, genitourinary tract, gastrointestinal tract, etc.

Klabax OD® should not be taken simultaneously with certain antihistamines and serotonergic drugs, as well as antipsychotics. The drug is contraindicated in severe pathologies of the kidneys and liver, as well as in patients with porphyrin disease.

Clarbact®

Also affects protein synthesis of pathogenic microorganisms. Active against all mycobacteria except Koch's Bacillus.

Clarbact® is absorbed quickly. Eating slows down absorption. Long-term antibiotic therapy is fraught with the development of superinfection (candidiasis). The antibiotic penetrates into human milk, so treatment of lactating women is possible if breastfeeding is stopped.

Clarithrosin®

Available in the form of yellow, film-coated tablets. The medication is taken orally regardless of food intake.

Clarithrosin® is prescribed for inflammation of the bronchial mucosa, lymphoid tissue of the pharynx, tonsils, paranasal sinuses, nosocomial pneumonia, hair follicle and oral infections. The drug is taken to prevent relapse of peptic ulcer disease.

Klacid®

Klacid ® interacts with the 50S ribosomal subunit. The drug can be taken in the treatment of three-year-old children. The drug is quickly absorbed from the gastrointestinal tract. Bioavailability reaches 50 percent. The production of β-lactamases does not affect the activity of Klacid. Most Staphylococcus strains are resistant to antibiotics.

Clerimed®

Refers to macrolides, its main active ingredient is clarithromycin®. The antimicrobial mechanism is based on the ability of the antibiotic to interact with the 50S ribosomal subunit, which negatively affects protein synthesis in the cell.

Kriksan®

Kriksan® is prescribed by doctors for infections of the respiratory tract, skin and ear inflammation. Indications also include chlamydia and mycobacteriosis. Medicines are taken with caution in case of renal or liver failure. When taken together with drugs that inhibit the activity of the blood coagulation system and prevent the formation of blood clots, it is necessary to monitor the prothrombin time.

Read further: We understand the compatibility and consequences of taking alcohol and antibiotics

Lecoclar®

Lekoklar® should not be prescribed to children under six months of age, since there is insufficient data on its effectiveness and safety at this age. The antibiotic is contraindicated if there is a history of hepatitis.

Fromilid® and Fromilid UNO®

Fromilid ® exhibits a bacteriostatic effect, but has a bactericidal effect on some strains. Fromilid® is prescribed to patients with acquired immune deficiency syndrome (for the prevention of treatment of bacterial infections). The drug is well absorbed when taken orally. The half-life averages about 5 hours.

Fromilid UNO ® is contraindicated in case of lactose intolerance. Medicines are not prescribed to patients under 18 years of age. Fromilid UNO® causes side effects in the gastrointestinal tract, skin and subcutaneous tissue, nervous and urinary systems, sensory and hematopoietic organs, heart, and musculoskeletal system. Upon admission, changes in laboratory parameters are noted. The medicine is available only by prescription.

Others

Analogs include Vero-Clarithromycin ® , Clarithromycin Protech ® , Clarithromycin SR ® , Ecositrin ® , Clarithromycin-OBL ® , Clarithromycin-Verte ® .

All drugs act bacteriostatically, they are active against gram+ cocci and intracellular and membrane pathogens, reach high concentrations in tissues, and have a low risk of developing cross-allergy with beta-lactams when taken.

Semi-synthetic 14-membered macrolides

When deciding what to replace Clarithromycin® with, doctors often prescribe the following drugs:

Rulid®

Rulid ® belongs to the pharmacological group of macrolides and azalides. The main active ingredient is roxithromycin. It is superior to erythromycin in pharmacokinetic and microbiological parameters. Increasing the dosage allows you to achieve a bactericidal effect.

The antibiotic has low toxicity. Active against Streptococcus, Listeria, Staphylococcus, Corynebacterium diphtheriae, Neisseria meningitidis, Legionella and Mollicutes. Drugs are prescribed for whooping cough, acute pharyngitis, chronic obstructive pulmonary disease, cercevitis, as well as for genital and odontogenic infections.

Esparoxi®

Esparoxi ® is effective in the treatment of diseases of bacterial etiology of the respiratory tract (pneumonia), ENT organs (otitis, sinusitis), skin (erysipelas) and urinary tract (urethritis). Therapy with this generic Clarithromycin® is carried out only after 12 years. The antibiotic is taken once a day, 300 mg or twice a day, 150 mg. If antibiotic therapy lasts more than 2 weeks, a clinical blood test is performed. The drug affects concentration and reduces psychomotor reactions.

Roxithromycin®

Roxithromycin ® is a semi-synthetic macrolide, the effect of which depends on the dosage: in high doses a bactericidal effect is achieved. Pathogens that synthesize enzymes that are capable of breaking down beta-lactam antibiotics are sensitive to it. Prescribed as a prophylaxis against bacteremia after dental procedures. The antimicrobial agent is widely used in pediatric practice and is prescribed to children from two months.

Side effects and contraindications

The instructions for the medicine indicate that the side effects of Klacid can be manifested by disorders of different systems:

• Digestive system: nausea, vomiting, abdominal pain, heartburn, pseudomembranous colitis, increased liver transaminases, jaundice.
• Nervous system: dizziness, spots before the eyes, sleep disturbance.
• Allergic reactions of varying severity, from urticaria to angioedema and anaphylactic shock.

According to patient reviews, the most common allergic reactions are in the form of a rash (urticaria) or digestive disorders. Other side effects are rare.

Patients with heart disease (arrhythmia) should take Klacid with caution due to some cardiotoxic effects of clarithromycin. Patients taking cardiac glycosides (digoxin), ergot alkaloids, antirheumatoid drugs, antiretrovirals, carbamazepine should consult a physician regarding drug compatibility before taking them, as clarithromycin alters the metabolism of these drugs

As a result of simultaneous administration of Klacid and other drugs, the effective concentration may increase and decrease, and side effects may increase.

According to the instructions, Klacida is contraindicated for pregnant women, especially in the first trimester. In the second and third trimester of pregnancy, Klacid can be taken only under strict indications, if the benefit to the mother outweighs the risk to the child, and it is not possible to replace Klacid with another medicine.

Directions for use and dosage selection for a child

Klacid is prescribed to children in the form of a suspension. You can purchase granules for its preparation at most pharmacies in the country. For ease of dosing, the package contains a measuring syringe or a special spoon with marks.

How to make a suspension from powder?

The method for preparing the syrup is indicated in the instructions for the drug. Preparing the suspension is very simple - you need to open a plastic bottle with granules, pour warm (but not hot) boiled water into it up to the mark and shake thoroughly until the suspension becomes almost homogeneous. The result should be an opaque whitish liquid containing a small amount of undissolved whitish particles and having a light fruity aroma.

The finished composition can be stored for 14 days at temperatures up to +30 degrees in a dark place. Before taking, the bottle of suspension should be shaken vigorously.

How long does the treatment last?

The therapeutic course of taking Klacid suspension for children is from five to ten days - the duration is determined by the attending physician based on the individual characteristics of the patient, his medical history, the diagnosed disease and the severity of the latter. You can take the medicine regardless of food intake. Infants can take the medicine with milk or an adapted mixture.

How to calculate the dosage?

The dosage of the antibacterial drug for children is selected depending on the patient’s body weight. For this reason, before starting calculations, it is recommended to weigh the child. Babies whose body weight is less than 8 kilograms (mostly infants under one year of age) take the medicine twice a day at the rate of 7.5 mg per kilogram. That is, if the baby weighs 6 kg, then the one-time volume of Klacid will be 45 mg. For small children who weigh more than 8 kg, the dosage is determined according to the table below.

Single volume, ml (at a concentration of clarithromycin in 5 ml of suspension, mg)	Patient's weight in kilograms
8-11	12-19	20-29	30-40
At a dosage of 125	2,5	5	7,5	10
At a dosage of 250	1,25	2,5	3,75	5

The dosage of Klacida is calculated taking into account body weight

Release form and composition of the medicinal product

Klacid is a medicine from the group of semi-synthetic antibacterial drugs - macrolides. Its pharmacological effect is provided by the active ingredient – ​​clarithromycin. Available in the form:

• oval bilayer tablets consisting of a white core and a yellow outer layer, each containing 125 or 250 mg of clarithromycin;
• powder for preparing a suspension for children - 250 mg / 5 ml.

The medicine is sold in pharmacies. It can only be purchased with a prescription. The shelf life of the tablets is 2 years from the date of issue, the finished suspension is 2 weeks from the date of preparation. Klacid should be stored at room temperature out of the reach of small children (but not in the refrigerator).

The main disadvantages of the drug include the relatively high price, side effects that most often develop from the gastrointestinal tract (however, drugs such as Linex help solve this problem - the doctor usually prescribes them along with an antibiotic) and the presence of a set of contraindications . That is, in fact, all the disadvantages of Klacid are inherent in almost all antibacterial drugs.

Antibiotic Klacid SR in tablet form

At the same time, the antibiotic in question has a number of advantages, including:

• anti-inflammatory effect;
• immunomodulatory effect;
• Compared to other antibiotics, Klacid is well tolerated by young patients (side effects when taking the drug by a child occur less frequently and are much less pronounced);
• convenient release forms that take into account the physiology of patients of different ages;
• the effect manifests itself very quickly - patient reviews indicate that a noticeable improvement in the condition is observed already on the second or third day of taking the medicine;
• wide spectrum of action, including infections of mycobacterial origin.

Klacid in gastroenterology

And another “narrow” specialization of Klacid is peptic ulcer of the stomach and duodenum. It has been proven that the vast majority of cases of these diseases are associated with infection with the bacterium Helicobacter pylori. She manages to survive in the aggressive hydrochloric acid environment of the stomach and contribute to ulceration of its walls. For many years, until the connection between ulcers and infection was discovered, the disease was considered chronic. However, the discovery of Helicobacter finally put an end to the permanent course of peptic ulcer disease. Today, even severe and multiple ulcerative lesions can be cured in just two weeks, during which a course of antibiotic therapy lasts. First-line drugs are Clarithromycin (Klacid), the penicillin antibiotic Amoxicillin and a drug from the group of proton pump inhibitors that can block the production of hydrochloric acid for a long time (Omeprazole, Pantoprazole, Rabeprazole and others).

About the drug

Today, this medicine is one of the most potent drugs with a wide spectrum of activity. This medication acts on gram-positive microbes and is also effective against gram-negative bacteria. Intracellular parasites such as chlamydia and mycoplasma, which are famous for their high resistance to other antibacterial drugs, are also sensitive to the drug.

Modern medicine is sounding the alarm that many antibiotics, especially cephalosporins and penicillins, can no longer have the desired effect, since microscopic organisms have managed to adapt, and in addition, they have also developed insensitivity to these drugs. In this regard, there are even more reasons for prescribing the drug “Klacid” in severe conditions in children and adults today. Next, let's talk about the use of medicine to treat young patients.

How it works?

The principle of action of Clarithromycin is based on its bacteriostatic and bactericidal properties against a wide range of microorganisms.
The drug binds tightly to a specific subunit of the microbe and irreversibly inhibits protein synthesis, which leads to the death of the bacterial cell. A variety of gram-positive and gram-negative microorganisms are sensitive to Clarithromycin, including:

• Staphylococcus aureus, the causative agent of many respiratory diseases;
• pneumoniae streptococcus, responsible for the development of pneumonia and other diseases;
• pyogenic and other types of pathogenic streptococcus;
• hemophilus influenzae;
• Moraxella;
• Helicobacter pylori;
• Bordetella, the causative agent of whooping cough;
• legionella, which causes legionellosis;
• clostridia;
• mycobacteria;
• Pseudomonas aeruginosa and others.

Separately, I would like to emphasize that Clarithromycin is one of the few existing antibiotics that can penetrate inside a bacterial cell.

This unique property inherent in macrolides allows the drug to maintain activity against intracellular pathogens that are indifferent to the action of most antibiotics. The indications for use of Clarithromycin are also based on the spectrum of activity.

Klacid 125, 250 mg description and instructions for children

The basis of the original drug "Klacid" is a semi-synthetic representative of macrolides, clarithromycin. The antibiotic exhibits antimicrobial activity against a number of different bacteria: groups of streptococcus and staphylococcus (in particular those producing β-lactamase), mycoplasma, mycobacteria (with the exception of tuberculosis), Haemophilus influenzae, the causative agent of gonorrhea, campylobacteriosis and Helicobacter pylori.

Can it be given to children?

The drug is used according to age dosages and based on the baby’s body weight. Depending on the general condition and age category to which the patient belongs, the preferred form of medication is chosen.

Indications for use

The drug is used:

• For infections of the nasal cavity and oropharynx (rhinitis, pharyngitis, etc.) and their complications (sinusitis, otitis) caused by sensitive microflora.
• For infectious lesions of the lungs and bronchi of streptococcal, staphylococcal etiology and other bacterial diseases with marked sensitivity to clarithromycin.
• In the complex treatment of Hp-associated gastritis.
• For skin infection.
• In the presence of mycobacterial inflammation (except tuberculosis).

Forms of release of the drug

Klacid is available as:

1. Coated tablets of 0.25 and 0.5 g.
2. Lyophilisate 500 mg, from which a solution for parenteral infusion is made.
3. Vials with a suspension of 125 and 250 mg in 5 ml.

Instructions for use

Children, depending on their body weight, are prescribed oral administration of the Klacida suspension from 6 months of age, usually 2 times a day. For children, according to their body weight, oral administration of the Klacida suspension is usually prescribed 2 times a day. If the child weighs less than 8 kg, then the single dosage is calculated as 7.5 mg per kilogram of weight. If the weight is over 8 kg, the prepared suspension is used according to the instructions.

According to the proposed calculations, in accordance with the weight category of the child, a single dose is:

• 8 - 11 kg: 2.5 ml is prescribed in the form of a suspension of 125 mg in 5 ml or 1.25 ml if the suspension contains 250 mg/5 ml.
• 12 - 19 kg: 5 ml if the 125 mg/5 ml form is chosen, or 2.5 ml of a suspension containing a substance of 250 mg in a standard volume.
• 20 – 29 kg: 7.5 or 3.75 ml at 125 mg or 250 mg per 5 ml, respectively.
• 30 – 40 kg: 10 ml (125 mg/5 ml) or 5 ml (250 mg/5 ml).

If a mycobacterial infection is detected, the single dose can be doubled.

Compound

The main component that causes the bacteriostatic effect is the macrolide – clarithromycin. The suspensions also contain additional flavorings, maltodextrin, sucrose, etc. The tablets are coated with an acid-resistant coating.

Side effects

Possible development of allergic reactions, effects on the mental state (deterioration of mood, psychosis), destruction of striated muscles, cholestasis, change in urine color, and there is a risk of bleeding.

Contraindications

The presence of individual intolerance to a group of macrolides, incl. due to the body's sensitization to them. Simultaneous use of colchicine, astemizole, pizopride, simvastatin and other statins.

Analogs

Clarithromycin is the active ingredient in the substances for suspensions “Fromilid” 125 mg in 5 ml and “Seidon-Sanovel” 125 and 250 mg in 5 ml. The tablet form is represented by the following drugs: “Ecositrin”, “Lecoclar”, “Arvicin”, “Coater”, “Zimbaktar” and the most budget-friendly “Clarithromycin”.

Reviews

1. Helped cope with mycoplasma. It happened several times that a child might get an acute respiratory infection, and everything was attributed to immature immunity, contact with viruses, until the doctor identified a mycoplasma infection. The course of treatment lasted almost 2 weeks. I had to buy 2 bottles (we were prescribed to drink 5 ml at a time). Now we are out of constant pain.
2. The instructions for “Klacida” are very voluminous, there are almost a sheet of contraindications and side effects. But when the choice arises between health and possible side effects, you have no doubt about the correctness of the prescriptions. They treated my son for bronchitis, everything turned out to be a minor stool disorder, but even that was corrected the next day with Atsipol.
3. I wish it came with a syringe. It seems to be more convenient for them to dose. Otherwise, the drug is not too scary, and it smells sweetish, although the child said that his mouth tastes bitter after taking it. You need to drink more liquid. It copes with the task. The ear was cured.

Diagnoses and nuances

If the indication for the use of Clarithromycin is the eradication of Helicobacter pylori, the localization of the ulcer is the intestines, a triple course may be prescribed. Its duration is 7-10 days. The drug is taken twice a day, 0.5 g in combination with twice the dose of Amoxicillin. In addition, take 20 mg of Omeprazole once a day.

An alternative ten-day program involves combining the described composition, taking 0.5 g of it twice a day in combination with 20 mg of Lanzoprazole. Also take Amoxicillin (1 g) twice a day.

A combination of Clarithromycin and Omeprazole may be prescribed for two weeks. During the day, the first drug is used three times, 0.5 g each, the second - once 40 mg. After the first two weeks, the program is continued only with Omeprazole, taking it 20-40 mg once a day for another two weeks.

In a similar way, you can combine the described remedy and Lanzoprazole. The antibiotic is taken every day three times, 0.5 g each, and the second drug is taken once 60 g. In the future, it may be necessary to use medications to control the production of hydrochloric acid in order to smooth out the symptoms of the ulcerative process.

Consequences of tuberculosis treatment

Tuberculosis is a serious disease whose treatment takes a long time. At the initial stage of the disease, the average duration of therapy is three months . With moderate severity of the disease, at least six months . Anti-tuberculosis therapy often leads to toxic poisoning of the body, since the liver and kidneys do not always cope with the load.

Repeated use of anti-tuberculosis drugs in some cases provokes an allergic reaction . It is expressed in skin rashes, itching, inflammation of the mucous surfaces. In the absence of timely assistance, Quincke's edema .

What you should pay attention to?

Side effects that occur during treatment require close attention. Their presence indicates that the drug is not suitable . In this case, a search is made for alternative options to combat the disease. Particularly dangerous side effects include signs of intoxication of the body. Among them :

• muscle pain;
• high body temperature;
• severe vomiting;
• bowel dysfunction;
• stomach pain;
• loss of consciousness.

Photo 2. Packaging of Clarithromycin in the form of tablets with a dosage of 500 mg. .

Immediate medical assistance should be provided if an allergic reaction develops. Antihistamines are being taken . It is possible to place the patient in a hospital. If side effects occur, Clarithromycin should be discontinued.

Antibiotic in phthisiology: what is it prescribed for?

Clarithromycin is one of the few drugs whose pharmacological group is macrolides, and they show effectiveness against Mycobacterium tuberculosis . Given the growth of tuberculosis bacteria resistant to first-line drugs taken for the disease, this medicine is included in the treatment regimen for patients as an alternative .

The medicine is also used to treat newly diagnosed diseases. To achieve the desired effect, the antibiotic is combined with other medications , for example, the drug is capable of synergism when combined with isoniazid and rifampin (first-line anti-tuberculosis drugs).

What does it help with?

Clarithromycin is indicated for the treatment of the following bacterial infections:

1. skin and soft tissues;
2. digestive organs ;
3. upper and lower respiratory tract .

Diseases for which the drug is prescribed include:

• inflammation of the middle ear ;
• inflammation of the sinuses ;
• chronic inflammation of the tonsils ;
• inflammation of the mucous and lymphoid tissue of the pharynx ;
• bronchitis, pneumonia , including community-acquired;
• infection of the middle and deep parts of the hair follicle , erysipelas, furunculosis;
• chlamydia, mycobacteriosis.

The medicine is used to reduce the frequency of relapses of intestinal ulcers.

Side effects

The drug may cause side effects. These include:

• itching and rash on the skin, intense sweating;
• violation of the perception of taste sensations ;
• abdominal pain , nausea, vomiting, diarrhea, bloating;
• inflammation of the tongue , disease of the oral mucosa
• increasing the lumen of blood vessels ;
• leukopenia, thrombocytopenia;
• candidiasis.

From the nervous system, dizziness, insomnia, psychosis, hallucinations, headache, anxiety, fear, drowsiness, paresthesia are possible.

An overdose of the drug causes impaired consciousness, severe abdominal pain, nausea and vomiting. You should stop taking the drug and rinse your stomach with activated charcoal or another absorbent.

Reference! of myasthenia gravis may increase .

What is the release form

The antibacterial agent “Clarithromycin” is presented in the pharmacy chain:

• as yellow, biconvex tablets coated with a special protective coating, with two layers visible at the break - packaged in 7 pcs., 10 pcs., and also 14 pcs.;
• as hard white-colored capsules containing a powder mass inside - packed in protective blisters of 7 pcs., 10 pcs., and also 14 pcs.;
• For the pediatric category of patients, a suspension for oral administration is produced - in dark glass bottles of 60 ml or 100 ml.

The optimal form is recommended by a specialist, based on the diagnosed pathology, as well as the age category of the patient.

Release form: in ampoules for injection

There is a solution for preparing a solution for infusion with a dosage of 500 mg . The package contains 1 bottle . Manufactured in the USA by the corresponding Abbott brand. One bottle of powder contains 500 mg of the active substance.

The medicine is taken:

1. for infections of the upper and lower respiratory tract (inflammation of the pharyngeal mucosa; inflammation of the tonsils and paranasal sinuses);
2. for infections mucosa (pneumonia);
3. with inflammatory disease of the middle ear;
4. with infection of the skin and soft tissues (a disease that occurs with the formation of superficial blisters with purulent contents; a pustular disease that occurs in the hair follicle; purulent inflammation of tissues with their melting and the formation of a purulent cavity);
5. for disseminated or localized bacterial infection caused by a slow-growing species of mycobacteria belonging to the group of species M or slowly growing species of mycobacteria belonging to the group of species avium complex;
6. local infections caused by psychrophilic photochromogenic microorganisms living in salty and fresh environments.

There is also a drug "ABBOTT", SpA (Italy) . One bottle contains 500 mg of active substance. Additional agents: polyhydroxy acid, caustic soda. When administering injections, it is important to adhere to the recommended dose indicated in the instructions, divided into 2 equal injections .

Injections for children

There is no data regarding the dosage of the drug in ampoules for children. It is prohibited to administer the contents intramuscularly. If the patient has kidney problems, the dose of the administered active substance should be halved.

Attention! Injections are usually a necessary measure of pharmacological treatment. If for some reason they are not suitable for you, discuss using a different form of the product with your doctor.

Properties of the drug, non-antimicrobial effects

Clarithromycin not only blocks the proliferation of pathogenic bacteria, but also eliminates the inflammatory process. The active components of Clarithromycin are processed by liver cells. With long-term treatment, and bilirubin increase . There is a risk of developing cholestatic jaundice . Against this background, the color of the teeth, tongue and skin changes. The effect on the kidneys is expressed in a change in the color of urine.

, confusion and headaches are observed while taking the medicine This affects a person's cognitive abilities. Performance decreases and health deteriorates. The opposite effect is also possible - the patient becomes excitable and restless. Insomnia, hallucinations and depression are observed.

Attention!

During treatment, it is recommended to take into account the maximum daily doses.
In children it is 1 gram , and for adults - 2 grams.

Features of the use of the medicine

In severe cases or the inability to take tablets and capsules, intravenous administration is prescribed at a dosage of 0.5 g per day for up to 5 days , then, if possible, the patient is transferred to taking the oral form. The duration of therapy depends on the individual indications of the patient.

Patients with chronic liver diseases require monitoring of serum enzymes during treatment. When taken together with drugs that affect thrombin by completely destroying it, constant evaluation of the extrinsic coagulation pathway is necessary.

Mechanism of action in combination with other drugs

When taken simultaneously with medications such as Cyclosporine, Cisapride, Rifabutin, Omeprazole, the antibiotic can increase their concentration in the blood. In the case of Omeprazole, the concentration of Clarithromycin itself increases slightly.

Itraconazole (an antifungal drug) increases the concentration of the antibiotic in the blood, thereby increasing its own concentration.

A twofold increase in Clarithromycin is possible when used together with Atazanavir (a medicine for the treatment of HIV infection).

Acts to reduce the concentration of the antiviral drug Zidovudine , used in the treatment of HIV infection.

The risk of hypoglycemia increases when taking an antibiotic and oral hypoglycemic agents or drugs that lower blood glucose at the same time.

Clarithromycin for children

Children under 12 years of age or weighing up to 33 kg take Clarithromycin in tablet form. The suspension, intended for children over 6 months, can be administered using a special syringe, and then give the child some liquid.

Usually the daily dose of medication is divided into two doses . Double dosage at one time is excluded, as there is a high risk of poisoning. The tablet form is indicated for children over 12 years of age .

Atypical pneumonia

Klacid is most appropriate to use for pneumonia in weakened patients, for example, elderly people, frequently ill children or patients with hospital-acquired pneumonia (that is, developed during hospitalization for another disease). This is due to the fact that patients with reduced immune defense are quite likely to develop atypical forms of pneumonia, caused not by gram-positive flora (pneumococci, staphylococci or moraxella), but by rarer and much more aggressive pathogens.

For example, pneumonia can be associated with bacteria that manage to penetrate inside the cells. Most antibiotics do not penetrate the cell membrane, and therefore these microorganisms are invulnerable to penicillins or cephalosporins. No matter how much you take Amoxicillin or inject Ceftriaxone for atypical pneumonia, there will be no effect. At the same time, Klacid at an average dose of 500 mg (as well as other macrolides, for example, Azithromycin) will work quickly and effectively.

Separately, I would like to note the effectiveness of Klacid against Legionnaires' disease, or Legionellosis - pneumonia caused by Legionella bacteria, which colonize in the humid environment of air conditioners. Legionella is absolutely immune to first-line antibiotics for pneumonia (penicillins, in particular Amoxicillin or its combination with clavulanate). That is why the world’s first outbreak of the disease, which occurred at a congress of legionnaires, claimed the lives of several dozen people. Legionellosis primarily affects people with weakened immune systems (the categories we mentioned above). If a doctor has reason to suspect atypical pneumonia in a patient, he prescribes macrolides as the drug of choice, and often the choice falls on Klacid.

Composition and release form: what the shell hides

Clarithromycin and Amoxicillin belong to the group of antibacterial drugs. They are prescribed for bacterial infections of various localizations. They do not affect fungi and viruses, do not affect the inflammatory process, but eliminate its cause. Usually used in combination with other drugs that relieve symptoms of the disease. Each antibiotic is described in detail in the table.

A drug	Clarithromycin	Amoxicillin
Pharmacological group	Macrolides	Penicillins
Active substance	Clarithromycin	Amoxicillin
Dosage	250, 500 mg	250, 500 mg
Release form	Film-coated tablets	Capsules, granules for the preparation of suspension for oral administration
Vacation at the pharmacy	On prescription	On prescription
Price	150-450 rubles	70-100 rubles
Manufacturer	Russia, Macedonia	Russia, Serbia

"Ecositrin": a drug based on clarithromycin

What other analogue can be found? "Klacid" can be replaced with "Ecositrin" tablets. This drug costs from 200 rubles. Each tablet contains 500 mg of clarithromycin and excipients. Medicine is prescribed for bacterial infections of the ear, nose, throat, bronchi and lungs. Used to treat skin infections and stomach ulcers. It is contraindicated to use Ecositrin in case of renal failure, sensitivity, or hypokalemia. The remaining contraindications coincide with the declared drug. The duration of treatment, unlike previous analogues, is 10-14 days. In some cases, it is advisable to take an antibiotic for six months.

Amoxicillin-based substitutes

If you have an intolerance to the active ingredients of the drug "Klacid", then you can choose a substitute with a different composition, for example, based on amoxicillin. This active substance belongs to the penicillin series of antibiotics. A popular representative is the Flemoxin tablets. There are also trade names of drugs: “Amoxicillin”, “Amosin”, “Ospamox”, “Ecobol” and others. “Klacid” or “Flemoxin” - which is better to choose? The latter drug has its advantages and disadvantages:

• "Flemoxin" should be taken three times a day, and "Klacid" - twice;
• penicillin antibiotics more often provoke digestive disorders;
• "Flemoxin" - dispersible tablets (can be dissolved in water);
• This analogue costs about 350 rubles. for 20 pcs.;
• "Flemoxin" helps with gastrointestinal diseases caused by microorganisms sensitive to it;
• This medicine can be used during pregnancy and to treat babies.

Inexpensive substitute for Clarithromycin

An analogue of "Klacida" can be found cheaply. Many consumer reviews are negative only because of the price of the antibiotic. Not every person can afford to buy tablets for almost 1000 rubles. There is a need to find a more affordable drug. This is what Clarithromycin became. It contains the same active ingredient as in the original product. However, the cost of the tablets is about 250 rubles. Moreover, the package will contain 14 pills, not 10. Unlike the expensive American drug, this medicine is produced in Russia.

The analogues' readings are the same. The difference is that the domestic medicine can also be used to treat gastrointestinal ulcers, but in combination with additional medications. This medication is not used in the same cases as its predecessor. It is unacceptable to give it to children under 12 years of age. If you choose between purchasing “Klacid” or “Clarithromycin” for a child, the first medicine in the form of a suspension will have an advantage.

What's better?

Clarithromycin is a more accessible drug, which provokes the activity of its use. However, patients note that the more expensive analogue has fewer side effects. Most often, this drug is prescribed for outpatient treatment of pneumonia, bronchitis, and skin inflammation. It has acquired incredibly significant aspects of relevance in the treatment of various dental problems.

Klacid is more expensive, but has a small list of contraindications, and thanks to additional ingredients it can be used in the treatment of children from the age of two. It is actively used in the treatment of sinusitis, rhinitis, pharyngitis and other infectious diseases (respiratory tract). Used in complex therapy for the treatment of pneumonia.

Medicine and healthComment

Which manufacturer is better

The antibiotic Clarithromycin is produced by many companies, both Russian and foreign (Asian countries, Eastern Europe). Different manufacturers ( Ranbaxy, KRKA, Teva, Pharmstandard Obolenskoye Pharmaceutical Enterprise, Sintez, AVVA-RUS ) may call the product differently: Clarithromycin-Teva, Clarithromycin OBL.

deviations when producing the drug . All these products of the pharmaceutical business remain effective in the main direction - against the treatment of infectious diseases, but the number of contraindications and side effects may vary.

Photo 1. Antibiotic Clarithromycin tablets, 500 mg, manufacturer - Sandoz.

This especially applies to the products of Obolensky FP . Doctors prescribe this drug in cases where there is no alternative. The drug from this company is not prescribed to children ( only from the age of 12 ), although Clarithromycin is indicated starting from of two . The same can be said for people with liver and cardiovascular diseases.

As for the treatment of tuberculosis, Clarithromycin is not considered at all as the main drug in its treatment.

Klacid

The drug is manufactured on the basis of clarithromycin by the transnational company Abbott . It goes on sale in the form of tablets ( 0.25 g and 0.5 g ), powders, including for injection.

Of all the analogues and derivatives based on clarithromycin, it is the most effective ; even the slightest deviations from technology are not allowed in its production.

Successfully fights tonsillitis diseases, bronchitis, tonsillitis, pharyngitis, middle ear diseases, whooping cough, scarlet fever, acne, boils.

It is not used against the treatment of tuberculosis . It differs from Clarithromycin in its trade name, but is based on the same active substance, bearing the same name as the original form.

There are practically no contraindications. Doctors prescribe Klacid even for children, but only if the condition does not require more gentle treatment (for example, for whooping cough, scarlet fever). It is better for pregnant women to refrain from using the medication.

The price per package is high and can reach up to a thousand rubles .

Sumamed

It differs in that it is based on another active ingredient - azithromycin. Sumamed is cheaper, the cost starts from 400 rubles per package.

It is sold in the form of tablets ( 0.25 g and 0.5 g ), capsules and powder for suspensions.

Photo 2. Sumamed capsules, 250 mg, manufacturer - Pliva.

It is impossible to say unequivocally whether it is better or worse, since both are macrolides , have a fairly strong effect and only a doctor can prescribe them, taking into account all the nuances of the disease. Not only the active substance differs, but also the set of side effects . So, if Klatsid mainly hits the psyche, then Sumamed hits the liver . Mainly used against streptococcal and staphylococcal infections. It is useless against Koha sticks.

Take once every 12 hours according to the instructions. The product has a narrower spectrum of action than Clarithromycin. Not used for infectious diseases in people with AIDS. The most famous supplier is Pliva Hrvatska.

Fromilid

The supplier is the Slovenian concern KRKA . Available in cardboard boxes of fourteen tablets. The price is quite high: from 350 rubles for a dosage of 0.25g and 500 for 0.5g .

Prescribed for otitis, bronchitis, sinusitis, pneumonia, purulent formations. Use twice a day in accordance with the instructions and exclusively as prescribed by a specialist.

Fromilid is based on a substance common to Clarithromycin, but some strains of bacteria are more resistant to the former.

Benefits of Clarithromycin

The main advantage of Clarithromycin is its ability to act not only outside, but also inside the cell infected with the bacterium. Moreover, the concentration of the drug inside the cell can exceed the extracellular concentration by ten times.

This quality makes it one of the most effective drugs in the treatment of intracellular infections, which are dangerous because they can occur latently for a long time and often become chronic. In addition, Clarithromycin:

• Active against staphylococci and streptococci, which in most cases are the cause of the disease. Moreover, it is four times stronger than erythromycin, and is the most effective macrolide against hemolytic streptococcus.
• It can help fight dangerous infections such as pulmonary chlamydia and mycoplasma, which are intracellular infections and cause severe bronchitis, pharyngitis and pneumonia.
• It is often included in treatment regimens for respiratory tract infections caused by mycobacteria, which are resistant to many antibiotics, including those with a bactericidal effect, since they have no targets for action.
• It has high activity against Legionella pneumophila, the causative agent of legionellosis, one of the severe infectious diseases affecting the respiratory system.
• It is capable of having a positive effect on the immune system, and this effect has been confirmed by studies in Japan, France, the USA and Germany.
• It has antioxidant properties and is able to fight not only infection, but also inflammation.

"Sumamed": a popular analogue

“Klacid” or “Sumamed” - which is better? This question often arises among people who have at least a little knowledge of medicine. These two drugs are compared because they are both macrolides. The substances included in their composition are different. The component of Sumamed is azithromycin. This medicine, as stated, is available in the form of tablets and suspension. A solution for internal administration is produced, but it is practically not in demand. The cost of a package of “Sumamed” is approximately 500 rubles. The drug is prescribed for the same purpose as Klacid. This analogue can also be used to treat sexually transmitted infections.

If the doctor prescribes Klacid or Sumamed, which is better to choose? The latter medicine is very popular. Another advantage is that you only need to take one tablet per day. Unlike Klacid, Sumamed should not be consumed during meals, much less mixed with milk.

What form of antibiotic is most effective?

In terms of absorption rate, and therefore action, intravenous injections and sublingual tablets .

When it is necessary to quickly and simultaneously influence the source of the disease, doctors prescribe this form directly.

It is more rational to take tablets and the drug in capsules when the work of the drug can begin with a slight delay.

Sometimes it is worth maintaining a certain concentration of a substance in the blood for quite a long time, and sometimes a powerful short-term reaction is necessary. Depending on this, there are drugs with different rates of release of drugs.

Application diagram

Indications for prescribing antibiotics are similar:

1. respiratory tract infections: tonsillopharyngitis, bronchitis, pneumonia;
2. ENT infections: otitis media, sinusitis;
3. inflammatory processes in the urinary tract: cystitis, urethritis, pyelonephritis;
4. genital infections;
5. damage to the skin and soft tissues.

The only difference is in the identified causative agent of the disease. The drug is prescribed taking into account examination data. It is important to know which bacteria caused the disease and whether they are resistant to the chosen drugs.

Clarithromycin and Amoxicillin are sometimes given together or sequentially. This treatment regimen is used for peptic ulcers and gastritis due to Helicobacter pylori infection. Antibiotics can get rid of dangerous bacteria, slow down the progression of the disease and prevent the development of complications.

The antibiotic dosage regimen is individual. The drug is prescribed taking into account the location and severity of the pathological process, the patient’s age and the presence of concomitant pathology. When taking antibacterial drugs, it is important to consider the following aspects:

1. The dosage of the medicine is determined by the doctor. You cannot change your treatment regimen on your own.
2. The course of therapy must be completed to the end. Do not interrupt treatment! Stopping an antibiotic prematurely will lead to the development of drug resistance. Pathogenic bacteria will remain in the body, acquire protection from antibiotics, and the disease will progress.

In the form of syrup

Clarithromycin in syrup form is produced by the following companies:

• KRKA PHARMA LLC. Suspension for oral administration - 125 mg/5 ml bottle. The active substance is contained in concentrations 125 and 5 ml.

  Other ingredients: Carbomerum, low molecular weight polyvinylpyrrolidone in insoluble form, silicate mineral, castor oil, xanthan, banana filler, potassium salt of sorbic acid, 2-hydroxypropane-1,2,3-tricarboxylic acid, polysorb, titanium oxide (E 171) , fructose.

  Suspension for oral use - 250 mg/5 ml bottle. The composition includes orange flavor, anhydrous citric acid, sodium saccharin, monoammonium glycyrrhizinate, E959, polysorb, glucose, E 202 preservative.

• LLC Pharmaceutical. The substance contains an active component in a dosage of 250 mg . Additional components: milk sucrose, corn starch, low molecular weight polyvinylpyrrolidone in insoluble form, sodium dodecyl sulfate, calcium stearate. The syrup is prescribed for similar diseases as the tablet form of the drug, but the active substances contained in the syrup are more quickly absorbed into the blood and help the body cope with the disease.

Attention! Medicinal syrups contain a high concentration of excess sugar, dyes, and flavors. If a similar product is available on the market in tablet form, it is better to give preference to it.

Brand and analogue which is better

We have come to a discussion of one of the most pressing questions: what is better, the branded but expensive Klacid, or its cheaper analogue, for example, Klabaks, Clarithromycin-Teva, Fromilid, and so on?

It is difficult to give a definite answer. The original drug and the analogue have the same formula, so in theory they should work the same. However, the effect of the drug largely depends on the excipients - after all, they determine both the rate of release and the characteristics of absorption and excretion of the active substance. It is the original drug, the formula of which was carefully selected over several years, that has the most balanced composition, providing the most favorable distribution indicators, and, consequently, effectiveness. This information is also confirmed by clinical studies, indicating that the brand and its analogues are never completely identical drugs.

And yet, it is impossible to say that Klacid’s analogues are a priori less effective than the original. “So what should we do?” - the reader will ask. — “Should I buy an expensive brand or limit myself to the more economical generic Klacida?” It is better to shift the burden of responsibility for making this decision onto the shoulders of the doctor. Some experts believe that in case of severe infections, you should not skimp on medications and it makes sense to buy only originals that guarantee 100% results. At the same time, if the disease is not dangerous, you can rely on analogues. In general, it is better to solve this dilemma together with a doctor and purely individually.

What is the drug and what is it used for?

The spectrum of action of this semi-synthetic antibiotic is very extensive. Aerobic and anaerobic, gram-positive and gram-negative bacteria are not resistant to Clarithromycin. It acts by inhibiting protein synthesis by binding bacterial ribosomes to the 50s subunit. The drug is rapidly absorbed and is excreted through the kidneys and gastrointestinal tract. The suspension has a higher level of absorption than tablets.

Important! Food significantly slows down the absorption of the drug, but does not interfere with bioavailability.

The medication is indicated for the following diseases:

• respiratory tract infections (sore throat, bronchitis, bronchialitis, pneumonia);
• infectious lesions of the skin and soft tissues (erysipelas, folliculitis);
• peptic ulcers of the duodenum and stomach;
• toxoplasmosis;
• chlamydia;
• mycobacteriosis;
• disease of the genitourinary system.

This drug also helps in the treatment of tuberculosis, but is used only as an alternative.

Clarithromycin is administered orally and intravenously.

Release form

The drug is released in the form:

1. tablets (regular and long-acting);
2. suspensions;
3. solution for droppers;
4. capsules.

It is impossible to accurately judge which of these forms is the most effective; it all depends on the specific situation, on which only the doctor can make a verdict.

To produce long-acting Clarithromycin tablets, a special technology is used, due to which the drug is released more slowly and its concentration in the blood increases.

Side effects

The antibiotic Clarithromycin should be used strictly as prescribed by a doctor, since taking it is fraught with many side effects:

• profuse sweating ;
• candidiasis;
• nausea, vomiting, abdominal pain;
• leukopenia;
• thrombocytopenia;
• rashes on the mucous membranes of the mouth;
• diarrhea;
• dizziness;
• hallucinations;
• paresthesia;
• sense of anxiety ;
• sleep disorders .

Clarithromycin strictly contraindicated:

1. children under one year of age;
2. pregnant and nursing mothers;
3. suffering from hyperkalemia, porphyria.

Attention! People suffering from cardiovascular diseases and kidney can take the medication, but under the strict supervision of a doctor.

Description of the antibiotic

Clarithromycin is several times more effective than erythromycin and exhibits better antibacterial properties .
Its formula is C38H69NO13. The name in Latin is Clarithromycinum. A semi-synthetic antibiotic suppresses the process of combining bacterial proteins and acts on pathogens located inside and outside the cells. The action of the drug is anti-inflammatory, immunomodulatory, mucoregulatory.

The medicine is effective against:

• aerobic bacteria;
• intracellular bacteria;
• anaerobic bacteria.

The action of the antibiotic allows it to be taken primarily for stomach ulcers to eradicate Helicobacter pylori.

The active substance has rapid absorption with two peaks of maximum concentration. It is excreted from the body in excrement.

What is the difference between the original drug and the differences from other forms of release?

Clarithromycin is produced by many pharmaceutical companies in different countries, under different names, but with one active ingredient.

Name	Manufacturer	Peculiarities
Clubax	India	Available in tablets of various dosages. Klabaks OD (long-acting) is available in dosage 500 mg one tablet. Prescriptions and contraindications will be identical to Clarithromycin.
Klacid	Italy	Available in tablets and powder for suspension. The suspension form is intended for children over 3 years of age .
Klacid	France	Release form: lyophilisate for the preparation of solution for injection. 1 bottle contains 500 ml of the main component. Prohibited for use by patients under 18 years of age .
Fromilid and Fromilid Uno	Slovenia	Available in regular and extended-release tablets. Indications and contraindications correspond to Clarithromycin.
Clarithromycin	Russia	Release form: tablets and capsules.
Claricite	Ukraine	Available in 250 mg tablets. Increases the concentration of cyclosporine in the blood plasma.
Binocular	Austria	Release form: 250 mg tablets.

All of these synonyms are based on clarithromycin, they differ in dosage and form. The spectrum of action, indications, contraindications, side effects and interactions with other drugs will be identical.

Photo 1. One of the analogues of Clarithromycin is Klacid SR “ABBOTT”.

The effectiveness of the drug in phthisiology

Clarithromycin shows effectiveness when used to treat tuberculosis with bacteria resistant to other drugs prescribed first. The medicine is especially active when combined with other anti-tuberculosis drugs.

The antibiotic is suitable for the treatment of children under 1 year of age (the appropriate form of the medicine must be taken into account). Dosage for mycobacterial infections will depend on the child's body weight.

Reference! If the child’s weight is less than eight kilograms, then the dosage will be calculated from 7.5 to 15 mg of suspension per 1 kg of weight.

The medicine is widely released in different countries under various trade names.

Cephalosporin series

"Klacid" - tablets and suspensions that can provoke allergies. With this outcome, the medication is often replaced with antibiotics belonging to the cephalosporon series, a new generation. You can replace the declared remedy with the following drugs: Suprax, Cephalexin, Ceftriaxone, Cefatoxime, and so on.

These antibiotics inhibit the growth of bacteria by damaging their wall. Doctors say that only Cephalexin is absorbed from the gastrointestinal tract. Therefore, other medications are prescribed for intravenous and intramuscular administration. If taken orally, there will be severe irritation of the mucous membranes of the stomach and intestines. The cost of the drug "Cefalexin" (16 tablets) is no more than 150 rubles. Affordable price is also important for the consumer.

pharmachologic effect

Semi-synthetic antibiotic from the group of macrolides of the second generation. Has a wide spectrum of antibacterial action. It disrupts the protein synthesis of microorganisms (binds to the 50S subunit of the ribosomal membrane of the microbial cell), and has a bacteriostatic effect on most pathogens. The clarithromycin metabolite 14-hydroxyclarithromycin has its own antibacterial activity (against Haemophilus influenzae it exceeds the activity of clarithromycin itself). The production of β-lactamases does not affect the activity of clarithromycin.

Active against gram-positive aerobic microorganisms: Streptococcus spp. (including Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Streptococcus agalactiae), Staphylococcus spp. (including Staphylococcus aureus), Listeria monocytogenes, Corynebacterium spp.; gram-negative microorganisms: Haemophilus influenzae, Haemophilus parainfluenzae, Haemophilus ducreyi, Moraxella (Branhamella) catarrhalis, Bordetella pertussis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Campylobacter jejuni, Helicobacter pylori, Borrelia burgdorferi; intracellular microorganisms: Legionella pneumophila, Chlamydia trachomatis, Chlamydia pneumoniae, Mycoplasma pneumoniae, Ureaplasma urealyticum; anaerobic microorganisms: Bacteroides melaninogenicus, Clostridium perfringens, Eubacterium spp., Peptococcus spp., Propionibacterium spp. (including Propionibacterium acnes); mycobacteria Mycobacterium spp. (including Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium leprae and others, except Mycobacterium tuberculosis); protozoa: Toxoplasma gondii.

Clarithromycin is bactericidal against Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Moraxella (Branhamella) catarrhalis, Neisseria gonorrhoeae, Campylobacter spp.

Gram-negative microorganisms of the family Enterobacteriaceae and Pseudomonas spp are resistant to clarithromycin.