• Clarithromycin Prophylaxis For Mac

    Clarithromycin Prophylaxis For Mac
    1. When To Start Mac Prophylaxis
    2. Clarithromycin Prophylaxis For Macbook Pro

    Opportunistic Infections - PCP and MAC. What are the 5 main opportuniistic infections for HIV patients? PCP, Crytpo, Toxo, CMV and MAC. When might you consider discontinuing a patients primary prophylaxis for MAC? (or also clarithromycin) What is the indication for secondary prophylaxis in MAC? Completion of the initial. Adverse effects were similar for both regimens. Given the low incidence of MAC during the study period due to increased use of prophylaxis and the results favoring clarithromycin at an early timepoint, the study was terminated early and new enrollments stopped. Macrolide resistance was detected in only one patient. Both azithromycin and clarithromycin are active agents for MAC prophylaxis in patients with late-stage acquired immunodeficiency syndrome (AIDS), although azithromycin may be the preferable agent because of fewer drug-drug interactions. Chaisson RE, Benson CA, Dube M, et al. Clarithromycin therapy for disseminated Mycobacterium avium-complex (MAC) in AIDS. Abstracts of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Anaheim, California, 1992;89l.

    Indications for BIAXIN: Mild to moderate susceptible pharyngitis/tonsillitis, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia, acute maxillary sinusitis, acute otitis media, uncomplicated skin and skin structure infections. Disseminated M. Treatment (with other antimycobacterials) and prophylaxis of disseminated Mycobacterium avium complex (MAC).

    Fast

    Adult: Pharyngitis/tonsillitis: 250mg every 12hrs for 10 days. Bronchitis: 250mg–500mg every 12hrs for 7–14 days. CAP, skin and skin structures: 250mg every 12hrs for 7–14 days.

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    Sinusitis: 500mg every 12hrs for 14 days. MAC: 500mg every 12hrs; continue indefinitely if improvement occurs. Severe renal impairment (CrCl 1000mg/day should not be coadministered with protease inhibitors. Separate zidovudine dose by at least 2hrs. Potentiated by CYP3A inhibitors (eg, itraconazole, saquinavir, atazanavir, ritonavir). Concomitant atazanavir: see Adults; consider alternative antibacterial therapy for indications other than MAC. May potentiate theophylline, omeprazole, phenytoin, digoxin, midazolam, alprazolam, triazolam, cyclosporine, hexobarbital, tacrolimus, alfentanil, bromocriptine, valproate, carbamazepine, tolterodine, itraconazole, methylprednisolone, cilostazol, vinblastine, quetiapine, maraviroc; monitor these and other drugs metabolized by CYP3A.

    Myopathy/rhabdomyolysis with statins; max 20mg atorvastatin/day, 40mg pravastatin/day; consider use of statin not dependent on CYP3A metabolism (eg, fluvastatin). Reduce colchicine dose if coadministration is necessary. Hypoglycemia with oral hypoglycemics/insulin; carefully monitor glucose. Oral anticoagulants: frequently monitor INR and prothrombin times. Hypotension with calcium channel blockers metabolized by CYP3A4 (eg, verapamil, amlodipine, diltiazem, nifedipine).

    Adverse Reactions: Abdominal pain, diarrhea, nausea, vomiting, dysguesia; hepatotoxicity, QT prolongation, C. Difficile associated diarrhea, hypersensitivity reactions. Metabolism: Hepatic.

    Elimination: Renal. Supported platforms environments and development. Generic Availability: XL, tabs (YES); susp (NO) How Supplied: XL tabs, tabs—60; Biaxin XL-Pac (14 x 500mg XL tabs)—4; Susp—50mL, 100mL Indications for BIAXIN: Triple therapy (w. Amoxicillin + lansoprazole or omeprazole) for treating patients with H. Pylori infection and duodenal ulcer disease.

    Dual therapy (w. Omeprazole) for treating active duodenal ulcer associated with H. Pylori infection. Adult: Triple therapy: clarithromycin 500mg + lansoprazole 30mg + amoxicillin 1g, all every 12hrs for 10 or 14 days. Or, clarithromycin 500mg + omeprazole 20mg + amoxicillin 1g, all every 12hrs for 10 days; may continue omeprazole for days 11–28 if ulcer was present at start. Dual therapy: clarithromycin 500mg every 8hrs + omeprazole 40mg once daily in the AM on days 1–14, then omeprazole 20mg once daily in the AM on days 15–28. Severe renal impairment (CrCl 1000mg/day should not be coadministered with protease inhibitors.

    Separate zidovudine dose by at least 2hrs. Potentiated by CYP3A inhibitors (eg, itraconazole, saquinavir, atazanavir, ritonavir). Concomitant atazanavir: see Adults; consider alternative antibacterial therapy for indications other than MAC. May potentiate theophylline, omeprazole, phenytoin, digoxin, midazolam, alprazolam, triazolam, cyclosporine, hexobarbital, tacrolimus, alfentanil, bromocriptine, valproate, carbamazepine, tolterodine, itraconazole, methylprednisolone, cilostazol, vinblastine, quetiapine, maraviroc; monitor these and other drugs metabolized by CYP3A. Myopathy/rhabdomyolysis with statins; max 20mg atorvastatin/day, 40mg pravastatin/day; consider use of statin not dependent on CYP3A metabolism (eg, fluvastatin).

    When To Start Mac Prophylaxis

    Reduce colchicine dose if coadministration is necessary. Hypoglycemia with oral hypoglycemics/insulin; carefully monitor glucose. Oral anticoagulants: frequently monitor INR and prothrombin times. Hypotension with calcium channel blockers metabolized by CYP3A4 (eg, verapamil, amlodipine, diltiazem, nifedipine). Adverse Reactions: Abdominal pain, diarrhea, nausea, vomiting, dysguesia; hepatotoxicity, QT prolongation, C. Difficile associated diarrhea, hypersensitivity reactions.

    Clarithromycin Prophylaxis For Macbook Pro

    Note: See Prilosec entry for more information on omeprazole. See Prevacid entry for more information on lansoprazole. See Amoxil entry for more information on amoxicillin. Metabolism: Hepatic.

    Elimination: Renal. Generic Availability: XL, tabs (YES); susp (NO) How Supplied: Tabs—60.

    Clarithromycin Prophylaxis For Mac