Claritromysiini

Claritromysiini is a macrolide antibiotic used to treat a range of bacterial infections. It is the form of the drug commonly referred to as clarithromycin in many language traditions and is supplied in oral and, in some settings, injectable forms.

Mechanism of action and spectrum: Claritromysiini works by binding to the 50S subunit of the bacterial ribosome, inhibiting protein synthesis. This action is largely bacteriostatic, though it can be bactericidal at high concentrations for certain organisms. It provides activity against many Gram-positive cocci (such as Streptococcus species), some Gram-negative bacteria (including Haemophilus influenzae and Moraxella catarrhalis), and atypical pathogens like Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella species. It is less effective against many enteric Gram-negative bacteria and Pseudomonas aeruginosa.

Clinical use: Claritromysiini is commonly prescribed for respiratory tract infections (including community-acquired pneumonia and sinusitis), skin and soft tissue infections, and certain cases of Helicobacter pylori eradication regimens when used with a proton pump inhibitor and another antibiotic. It is sometimes used as an alternative for patients with penicillin allergy. In H. pylori therapy, regimens typically combine claritromysiini with another antibiotic and a proton pump inhibitor for a short course.

Pharmacokinetics and interactions: It is well absorbed orally, though food can affect the rate of absorption. Claritromysiini is primarily metabolized in the liver and acts as an inhibitor of the cytochrome P450 system, notably CYP3A4, leading to potential drug interactions with other medications such as certain statins, anticoagulants, and antifungals. Concomitant use of antacids or medications that prolong the QT interval should be carefully managed due to interaction risks.

Adverse effects and considerations: Common adverse effects include gastrointestinal upset, taste disturbance, and abnormalities in liver function tests. Serious adverse events are uncommon but can include hepatotoxicity and hypersensitivity reactions. Use is cautioned in individuals with liver disease, those at risk for QT prolongation, and during pregnancy or lactation unless clearly indicated.