Clarger is an injectable form of Clarithromycin, a macrolide antibiotic used for severe bacterial infections when oral administration is not feasible.
Composition
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Active Ingredient: Clarithromycin – 500 mg/vial (as Clarithromycin Lactobionate).
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Excipients: May include lactose, sodium hydroxide (for pH adjustment).
Mechanism of Action
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Bacteriostatic (inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit).
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Effective against:
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Gram-positive bacteria (Staphylococcus aureus, Streptococcus pneumoniae).
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Atypical pathogens (Mycoplasma, Legionella, Chlamydia).
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Some Gram-negative bacteria (H. influenzae, Moraxella catarrhalis).
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Mycobacteria (Mycobacterium avium complex – MAC).
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Dosage & Administration
Adults:
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500 mg every 12 hours (IV infusion over 60 minutes).
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Switch to oral therapy as soon as clinically appropriate.
Renal/Hepatic Impairment:
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Severe renal impairment (CrCl <30 mL/min): Reduce dose by 50% (e.g., 250 mg 12 hourly).
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Liver disease: Use with caution (risk of QT prolongation).
Pediatrics:
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Not typically recommended for IV use in children (prefer oral suspension).
Uses (Indications)
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Severe respiratory tract infections (pneumonia, exacerbations of chronic bronchitis).
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Community-acquired pneumonia (CAP)Â (including atypical pneumonia).
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Mycobacterial infections (e.g., MAC in HIV patients).
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Skin & soft tissue infections (SSTI).
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H. pylori eradication (in combination therapy).
Storage
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Unreconstituted vials: Store below 25°C, protect from light & moisture.
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Reconstituted solution:
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Stable for 24 hours at 2–8°C (refrigerated).
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Use immediately if stored at room temperature.
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Do not freeze.
Recommendations
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Monitor liver enzymes & ECGÂ (risk of hepatotoxicity & QT prolongation).
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Avoid in patients with known macrolide allergy.
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Drug interactions:
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CYP3A4 inhibitors/inducers (e.g., ketoconazole, rifampin).
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Warfarin (increased INR risk).
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Statins (risk of rhabdomyolysis).
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Important Note
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Not first-line for severe sepsis (prefer beta-lactams in critically ill patients).
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Pregnancy (Category C): Use only if benefits outweigh risks.
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QT Prolongation Risk: Avoid in patients with arrhythmias or electrolyte imbalances.
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IV-to-Oral Switch: Transition as soon as possible to reduce complications.
Side Effects
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Common: Nausea, diarrhea, metallic taste, injection site reactions.
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Serious: Hepatotoxicity, QT prolongation, C. difficile colitis.
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