Clarithromycin =============== **PD Dialyzability**: Uncertain Pharmacokinetic Parameters [1]_ [2]_ -------------------------------------- ======= ====== /////// |pk| ======= ====== |pk1| |v1| |pk2| |v2| |pk3| |v3| |pk4| |v4| |pk5| |v5| |pk6| |v6| |pk7| |v7| ======= ====== CAPD Dosing: [3]_ [4]_ [5]_ ---------------------------- * 250mg PO BID CCPD Dosing --------------- * No literature identified. Extrapolate dosing from CAPD dosing recommendations Indication Specific PD Dosing: ---------------------------------- * Catheter-related infections: 500mg as loading dose, then 250mg PO BID X 2-3 Weeks (3 weeks if *Pseudomonas aeruginosa*) [6]_ [7]_ * Surgical prophylaxis (dental, endoscopic, gynecological, abdominal, pelvic procedures): 500mg PO 1 hour preoperatively [8]_ Literature Summary: -------------------- +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | Title | Patient | Intervention | Outcome | Note | +========+==================================+==============+============================================================================+===================+ | |L1| | - CAPD | |L4| | - |L5| | - |L7| | | [9]_ | - 64 year old male | | - |L6| | - |L8| | | | - |L2| | | | | | | - |L3| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L9| | - CAPD | |L10| | - |L11| | - No ADR reported | | [10]_ | - 65 year old male | | - |L12| | | | | - |L13| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L14| | - CAPD | |L15| | - |L16| | - |L17| | | [11]_ | - |L18| | | - |L19| | | | | - |L20| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L21| | - CAPD | |L22| | - Symptom improvement | - |L23| | | [12]_ | - |L24| | | | - |L25| | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L26| | - CAPD | |L27| | - Clarithromycin therapy was immediately discontinued | - |L28| | | [13]_ | - 50 year old male | | - |L29| | | | | - |L30| | | | | | | - |L31| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L32| | - CCPD | |L33| | - Symptom improvement | - No ADR reported | | [14]_ | - 38 year old male | | - MIC attainment | | | | - |L34| | | | | | | - |L35| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L36| | - CCPD | |L37| | - Wound healing | - |L38| | | [15]_ | - 43 year old female | | - |L39| | | | | - |L40| | | | | | | - |L41| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ References ------------ .. [1] Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, et al. DrugBank: a comprehensive resource for in silico drug discovery and exploration. Nucleic Acids Res. 2006 Jan 1;34(suppl_1):D668–72. .. [2] American Pharmacist Association. Drug information handbook: a comprehensive resource for all clinicians and healthcare professionals [Internet]. Hudson, Ohio: American Pharmacist association; 2012 [cited 2018 Jan 24]. Available from: http://online.lexi.com.login.ezproxy.library.ualberta.ca/lco/action/home?siteid=1 .. [3] Gilbert B, Robbins P, Livornese LL. Use of Antibacterial Agents in Renal Failure. Med Clin North Am. 2011;95:677–702. .. [4] Aronoff GR. Drug prescribing in renal failure: dosing guidelines for adults and children. 5th ed. Philadelphia, PA: American College of Physicians; 2007. .. [5] Adjusting oral antibiotics to estimated creatinine clearance [Internet]. [cited 2018 Jan 24]. Available from: http://www.vhpharmsci.com/VHFormulary/Tools/ADJUSTING%20ORAL%20ANTIBIOTICS.pdf .. [6] Li PK-T, Szeto CC, Piraino B, Bernardini J, Figueiredo AE, Gupta A, et al. Peritoneal Dialysis-Related Infections Recommendations: 2010 Update. Perit Dial Int. 2010;30(4):393–423. .. [7] Szeto C-C, Li PK-T, Johnson DW, Bernardini J, Dong J, Figueiredo AE, et al. ISPD Catheter-Related Infection Recommendations: 2017 Update. Perit Dial Int. 2017 Mar 1;37(2):141–54. .. [8] Saxena R, West C. Peritoneal Dialysis: A Primary Care Perspective. J Am Board Fam Med. 2006;19(4):380–389. .. [9] Miyashita E, Yoshida H, Mori D, Nakagawa N, Miyamura T, Ohta H, et al. Mycobacterium avium complex-associated peritonitis with CAPD after unrelated bone marrow transplantation. Pediatr Int Off J Jpn Pediatr Soc. 2014;56(6):e96–8. .. [10] Tang S, Tang AW, Lam WO, Cheng YY, Ho YW. Successful treatment of Mycobacterium fortuitum without Tenckhoff catheter removal in CAPD. Perit Dial Int. 2003;23(3):304–305. .. [11] Tse KC, Li FK, Tang S, Lam MF, Chan TM, Lai KN. Delusion of worm infestation associated with clarithromycin in a patient on peritoneal dialysis. Perit Dial Int J Int Soc Perit Dial. 2001;21(4):415–6. .. [12] Hevia C, Bajo M. Peritoneal catheter exit-site infections caused by rapidly-growing atypical mycobacteria. Nephrol Dial Ldots. 2000;(May 1997):1458–1460. .. [13] Steinman MA, Steinman TI. Clarithromycin-associated visual hallucinations in a patient with chronic renal failure on continuous ambulatory peritoneal dialysis. Am J Kidney Dis. 1996;27(1):143–146. .. [14] Lang CL, Chiang CK, Hung KY, Wu KD. Campylobacter jejuni peritonitis and bacteremia in a patient undergoing continuous ambulatory peritoneal dialysis. Clin Nephrol. 2009;71(1):96–98. .. [15] Gourzelis N, Margassery S, Bastani B. Successful treatment of severe Mycobacterium fortuitum exit-site infection with preservation of the Tenckhoff catheter. Perit Dial Int. 2005;25(6):607–608. .. |pk| replace:: Clarithromycin .. |pk1| replace:: Molecular Weight (Da) .. |pk2| replace:: Plasma Protein Binding (%) .. |pk3| replace:: Volume of Distribution (L/Kg) .. |pk4| replace:: Hepatic Metabolism .. |pk5| replace:: Excreted Unchanged (%) .. |pk6| replace:: Half-Life; Normal Renal Function (hours) .. |pk7| replace:: Half-Life; ESRD (hours) .. |v1| replace:: 747.95 .. |v2| replace:: 70 .. |v3| replace:: No Data .. |v4| replace:: Clarithromycin is a CYP3A4 substrate as well as a strong CYP3A4 inhibitor .. |v5| replace:: 20-30 .. |v6| replace:: 2.3-6.0 .. |v7| replace:: No Data .. |L1| replace:: Mycobacterium avium complex-associated peritonitis in a patient on continuous ambulatory peritoneal dialysis. .. |L2| replace:: Presenting with weakness, worsening abdominal pain, hypotension and repeated falling .. |L3| replace:: Diagnosed with peritonitis due to *Mycobacterium avium* complex .. |L4| replace:: Clarithromycin 250mg PO BID + Ethambutol 1.2g PO + Rifabutin 150mg PO x 2 weeks .. |L5| replace:: Abdominal symptoms improved over 2 weeks .. |L6| replace:: 5 weeks later patient developed gangrene of right foot and passed away due to ongoing sepsis .. |L7| replace:: No ADR reported .. |L8| replace:: Multiple antibiotic regimen employed .. |L9| replace:: Successful treatment of Mycobacterium fortuitum peritonitis without Tenckhoff catheter removal in CAPD. .. |L10| replace:: Clarithromycin 250mg PO BID + Levofloxacin 300mg PO daily .. |L11| replace:: Peritoneal effluent became clear .. |L12| replace:: No further relapse thereafter .. |L13| replace:: Relapse of peritonitis due to *Mycobacterium fortuitum* .. |L14| replace:: Delusion of worm infestation associated with clarithromycin in a patient on peritoneal dialysis. .. |L15| replace:: Clarithromycin 250mg PO TID + Terfenadine + Antitussives .. |L16| replace:: Psychiatrist consulted .. |L17| replace:: Delirium and visual hallucination associated with clarithromycin regimen .. |L18| replace:: 49 year old male presenting with delusions of worm infestation .. |L19| replace:: Patient treated with low dose oral haloperidol until completion of antibiotic regimen and symptom improvement .. |L20| replace:: Started clarithromycin 1 week prior for unspecified chest infection .. |L21| replace:: Peritoneal catheter exit-site infections caused by rapidly-growing atypical mycobacteria. .. |L22| replace:: Clarithromycin 200mg PO Q12H .. |L23| replace:: 1 of 5 patients experienced gastric intolerance requiring discontinuation of clarithromycin regimen .. |L24| replace:: 5 patients presenting with exit-site infections .. |L25| replace:: Duration of therapy ranged from 1.5-4 months .. |L26| replace:: Clarithromycin-associated visual hallucinations in a patient with chronic renal failure on continuous ambulatory peritoneal dialysis. .. |L27| replace:: Clarithromycin 500mg PO BID .. |L28| replace:: Visual hallucination associated with clarithromycin therapy .. |L29| replace:: Visual hallucination disappeared within 24 hours of stopping therapy .. |L30| replace:: Presenting with sudden onset of visual hallucination hours after starting clarithromycin therapy .. |L31| replace:: Clarithromycin initially prescribed for treatment of acute bronchitis .. |L32| replace:: Campylobacter jejuni II peritonitis in a CCPD patient: Cure by oral clarithromycin. .. |L33| replace:: Clarithromycin 250mg PO BID x 12 days .. |L34| replace:: Presenting with symptoms of acute peritonitis .. |L35| replace:: Diagnosed with peritonitis due to *Campylobacter jejuni* .. |L36| replace:: Successful treatment of severe Mycobacterium fortuitum exit-site infection with preservation of the Tenckhoff catheter. .. |L37| replace:: Clarithromycin 500mg PO BID x 2 weeks .. |L38| replace:: Nausea, vomiting, diarrhea resulting in discontinuation of clarithromycin therapy. .. |L39| replace:: Patient experienced nausea, vomiting, diarrhea while on clarithromycin therapy, resulting in change of antibiotic to levofloxacin. .. |L40| replace:: Presenting with two fluctuant masses from PD catheter site and purulent discharge .. |L41| replace:: Diagnosed with exit-site infection due to *Mycobacterium fortuitum*