Author/Editor		Jerman, Alenka
Title		Klaritromicin (Fromilid) - več kot standardni makrolid
Translated title		Clarithromycin (Fromilid) - more than a standard macrolide
Type		članek
Source		Krka Med Farm
Vol. and No.		Letnik 18, št. 29
Publication year		1997
Volume		str. 6-16
Language		slo
Abstract		Clarithromycin is a new semisynthetic macrolide antibiotic. In addition to gram-positive and certain gram-negative organisms, and anaerobes, the antimicrobial spectrum of clarithromycin also includes intracellular pathogens (mycoplasmas, chlamydiae and legionellae) and atypical mycobacteria. Against the majority of pathogens, clarithromycin is twice to four times as active as erythromycin. Moreover, in the body it exerts an additive or synergistic action with its active metabolite, 14-hydroxyclarithromycin. The tissue concentrations of clarithromycin are higher than serum concentrations, but it does not accumulate in the body. It is cleared from the body through the kidneys and liver. The serum half-life of clarithromycin affords a twice-daily dosing regimen. Clarithromycin is particularly effective in the treatment of respiratory tract infections and in the eradication of H. pylori in the management of gastric and duodenal ulcer. Infection with H. pylori is the major risk factor for the recurrence of the ulcer disease. The clinical experience has furnished evidence of successful treatment of dermal and subdermal infections and infections of the genitourinary tract, as well as of Lyme disease and infections due to atypical mycobacteria in patients with AIDS. The safety of clarithromycin has been confirmed by data on side effects which are normally mild to moderate and occur in up to 10% of patients. Clarithromycin may be administered to children, adults and the elferly. There are insufficient data on the risk of harmful effects during pregnancy and nursing. Therefore, the use of clarithromycin in pregnant or nursing women requires that the potential benefits be weighed against the possible risk.
Summary		Klaritoromicin je nov polsintezni makrolidni antibiotik. Protimikrobni spekter klaritromicina vključuje poleg po Gramu pozitivnih in nekaterih po Gramu negativnih mikroorganizmov ter anaerobov tudi znotrajcelične povzročitelje (mikroplazme, klamidije in legionele) in neptične mikobakterije. Na večino povzročiteljev deluje 2- do 4-krat bolj učinkovito kot eritromicin, poleg tega pa deluje v telesu še aditivno oziroma sinergistično s svojim aktivnim presnovkom 14-hidroksiklaritromicinom. V tkivu dosega večje koncentracije kot v serumu, vendar se v telesu ne kopiči. Izloča se skozi ledvice in jetra. Razpolovni čas v serumu omogoča dajanje dvakrat na dan. Klaritromicin je učinkovit predvsem pri zdravljenju okužb na dihalih in pri odstranitvi bakterije H. pylori, ki spremlja razjedo na želodcu ali dvanajstniku. Okužba s H. pylori pa je najpomembnejši dejavnik tveganja za ponovitev ulkusne bolezni. Izkušnje kažejo na uspešno zdravljenje okužb kože in podkožja ter okužb sečil in rodil, pa tudi lymske borelioze in okužb z netipičnimi mikobakterijami pri bolnikih z aidsom. Klinične izkušnje potrjujejo varnost klaritromicina. Stranski učinki se pojavljajo pri največ 10% bolnikov in so praviloma blagi do zmerni. Lahko ga dajemo otrokom, odraslim in ostarelim. Ker nimamo dovolj podatkov o morebitnih škodljivih učinkih jemanja klaritromicina med nosečnostjo in dojenjem, ga dajemo v teh obdobjih le po skrbni presoji o koristnosti zdravljenja glede na možno tveganje.
Descriptors		ANTIBIOTICS, MACROLIDE CLARITHROMYCIN RESPIRATORY TRACT INFECTIONS PEPTIC ULCER HELICOBACTER PYLORI ERYTHROMYCIN GRAM-NEGATIVE ANAEROBIC BACTERIA GRAM-POSITIVE BACTERIA MYCOBACTERIUM PHARMACOKINETICS CLINICAL MEDICINE