Biaxin: Effective Macrolide Antibiotic for Bacterial Infections
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Biaxin (clarithromycin) is a semi-synthetic macrolide antibiotic indicated for the treatment of a wide spectrum of bacterial infections. It functions by inhibiting protein synthesis in susceptible bacteria, thereby halting their growth and proliferation. This medication is commonly prescribed for respiratory tract infections, skin and soft tissue infections, and Helicobacter pylori eradication in combination therapy. Available in both immediate-release and extended-release formulations, Biaxin offers clinicians a versatile option for tailored patient care.
Features
- Active ingredient: Clarithromycin
- Available forms: Tablets (250 mg, 500 mg), extended-release tablets (500 mg), granules for oral suspension (125 mg/5 mL, 250 mg/5 mL)
- Mechanism of action: Binds to the 50S ribosomal subunit, inhibiting bacterial protein synthesis
- Broad-spectrum activity against Gram-positive and some Gram-negative bacteria, as well as atypical pathogens
- FDA-approved for multiple indications including community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, pharyngitis/tonsillitis, and uncomplicated skin/skin structure infections
Benefits
- High clinical efficacy rates in treating respiratory tract infections
- Excellent tissue penetration, particularly in lung and skin tissues
- Convenient twice-daily dosing regimen for most indications
- Demonstrated safety profile through extensive clinical use
- Effective component in H. pylori eradication therapy
- Available in pediatric formulations for appropriate age groups
Common use
Biaxin is primarily prescribed for bacterial infections including:
- Community-acquired pneumonia (mild to moderate)
- Acute bacterial exacerbation of chronic bronchitis
- Acute maxillary sinusitis
- Pharyngitis and tonsillitis caused by Streptococcus pyogenes
- Uncomplicated skin and skin structure infections
- Helicobacter pylori eradication (in combination with other antibiotics and acid suppressants)
- Mycobacterium avium complex (MAC) prophylaxis and treatment in HIV patients
Dosage and direction
Adults (immediate-release tablets):
- Respiratory/skin infections: 250-500 mg every 12 hours for 7-14 days
- H. pylori eradication: 500 mg twice daily in combination therapy for 10-14 days
- MAC prophylaxis: 500 mg twice daily
Adults (extended-release tablets):
- 1000 mg (two 500 mg tablets) once daily with food for 7-14 days
Pediatric patients:
- 7.5 mg/kg twice daily (maximum 500 mg twice daily) for 10 days
- Oral suspension available for children unable to swallow tablets
Take with food or milk to minimize gastrointestinal upset. Complete the full course of therapy even if symptoms improve.
Precautions
- Use with caution in patients with renal impairment (dose adjustment required for CrCl <30 mL/min)
- Monitor liver function tests during prolonged therapy
- May prolong QT interval; use caution in patients with known QT prolongation, electrolyte imbalances, or concurrent QT-prolonging drugs
- Not recommended during pregnancy unless clearly needed (Category C)
- Excreted in breast milk; consider alternative feeding options
- May cause dizziness; advise patients about operating machinery
- Superinfections including pseudomembranous colitis may occur
Contraindications
- Known hypersensitivity to clarithromycin, other macrolides, or any component of the formulation
- Concomitant administration with cisapride, pimozide, ergotamine, or dihydroergotamine
- History of cholestatic jaundice/hepatic dysfunction with prior clarithromycin use
- Patients with hypokalemia or hypomagnesemia
- Concomitant use with colchicine in patients with renal or hepatic impairment
- Known QT prolongation or ventricular arrhythmias including torsades de pointes
Possible side effect
Common (≥1%):
- Diarrhea (6%)
- Nausea (6%)
- Abnormal taste (6%)
- Dyspepsia (5%)
- Abdominal pain (5%)
- Headache (4%)
Less common (<1%):
- Vomiting, flatulence, oral moniliasis
- Transaminase elevations
- Rash, pruritus
- Dizziness, insomnia
- Hearing loss (usually reversible)
Rare but serious:
- QT prolongation and torsades de pointes
- Hepatotoxicity including hepatic failure
- Pseudomembranous colitis
- Stevens-Johnson syndrome
- Acute renal failure
- Reversible hearing loss
Drug interaction
Biaxin is a strong CYP3A4 inhibitor with numerous significant interactions:
- Contraindicated with: Cisapride, pimozide, ergot derivatives
- Requires dose adjustment: Colchicine, digoxin, theophylline
- Increased concentrations of: Statins (increased risk of rhabdomyolysis), benzodiazepines, carbamazepine, cyclosporine, tacrolimus, sildenafil
- May reduce effectiveness of: Oral contraceptives (recommend backup method)
- Antacids containing aluminum or magnesium may decrease absorption
- Interacts with antiretroviral agents including ritonavir
Missed dose
Take the missed dose as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain consistent timing between doses for optimal antibiotic levels.
Overdose
Symptoms may include severe nausea, vomiting, diarrhea, and abdominal pain. Hepatic dysfunction and hearing loss have been reported. QT prolongation and arrhythmias may occur. Treatment is supportive with ECG monitoring. Gastric lavage may be considered if presented soon after ingestion. Not removed by hemodialysis.
Storage
Store at 20-25°C (68-77°F). Keep container tightly closed. Protect from light and moisture. Keep out of reach of children. Oral suspension should be reconstituted with water and may be stored at room temperature for 14 days. Do not freeze. Discard any unused medication after completion of therapy.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. The prescribing physician should be consulted for specific dosing and treatment recommendations based on individual patient factors.
Reviews
Clinical studies demonstrate Biaxin’s efficacy with cure rates of 85-95% for respiratory infections. Physicians appreciate its broad spectrum coverage and convenient dosing. Patients report generally good tolerance, though taste disturbance is commonly noted. The extended-release formulation shows improved gastrointestinal tolerability. Many clinicians consider it a valuable option for community-acquired pneumonia and H. pylori eradication protocols.