Biaxin (clarithromycin) is a semi-synthetic macrolide antibiotic indicated for the treatment of a wide range of mild to moderate bacterial infections caused by susceptible organisms. Its extended spectrum of activity and well-established pharmacokinetic profile make it a reliable choice in both community and hospital settings for respiratory, skin, and soft tissue infections. The drug functions by inhibiting bacterial protein synthesis, effectively halting the growth and spread of pathogenic bacteria. Available in both immediate and extended-release formulations, Biaxin offers dosing flexibility tailored to specific clinical indications and patient needs.

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)
• Drug class: Macrolide antibiotic
• Mechanism: Binds to the 50S ribosomal subunit, inhibiting bacterial protein synthesis
• Broad-spectrum activity against Gram-positive and some Gram-negative aerobes, as well as atypical pathogens
• FDA-approved for use in adults and pediatric patients (≥6 months for suspension, ≥12 years for tablets)

Benefits

• Effectively treats common community-acquired respiratory infections including pneumonia, acute exacerbation of chronic bronchitis, and acute maxillary sinusitis
• Demonstrated efficacy against skin and soft tissue infections of mild to moderate severity
• Used in combination regimens for Helicobacter pylori eradication in peptic ulcer disease
• Extended-release formulation allows for convenient twice-daily dosing, improving adherence
• Generally well-tolerated with a established safety profile across multiple patient populations
• Available in pediatric-appropriate formulations for age-appropriate dosing

Common use

Biaxin is commonly prescribed for bacterial infections including acute otitis media in children, pharyngitis/tonsillitis, community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, and uncomplicated skin and skin structure infections. It is also used as part of combination therapy for the eradication of Helicobacter pylori to reduce the risk of duodenal ulcer recurrence. Off-label uses may include treatment of certain mycobacterial infections, particularly Mycobacterium avium complex (MAC) in HIV patients, and as an alternative for patients with penicillin allergies where appropriate.

Dosage and direction

Dosage varies by indication, formulation, and patient factors. For most infections in adults: 250-500 mg orally every 12 hours for 7-14 days. Extended-release tablets: 1000 mg (two 500 mg tablets) once daily for 7-14 days. Pediatric dosage based on body weight: 7.5 mg/kg twice daily (maximum 500 mg twice daily). For H. pylori eradication: triple therapy with Biaxin 500 mg, amoxicillin 1000 mg, and lansoprazole 30 mg all twice daily for 10-14 days. Take with or without food; extended-release tablets should be taken with food. Complete the full course of therapy even if symptoms improve.

Precautions

Use with caution in patients with renal impairment (creatinine clearance <30 mL/min); dosage adjustment recommended. Monitor for development of Clostridium difficile-associated diarrhea. May exacerbate weakness in patients with myasthenia gravis. Use during pregnancy only if clearly needed (Pregnancy Category C). Clarithromycin is excreted in breast milk; caution advised during breastfeeding. May cause QT prolongation; use with caution in patients with known QT prolongation, electrolyte imbalances, or those taking other QT-prolonging drugs. Hepatic function should be monitored in patients with pre-existing liver disease.

Contraindications

Known hypersensitivity to clarithromycin, erythromycin, or other macrolide antibiotics. Concomitant administration with cisapride, pimozide, astemizole, terfenadine, ergotamine, or dihydroergotamine. Patients with history of cholestatic jaundice/hepatic dysfunction associated with prior clarithromycin use. Concomitant use with colchicine in patients with renal or hepatic impairment. Concomitant use with lomitapide. Patients with hypokalemia or hypomagnesemia. History of QT prolongation or ventricular arrhythmias including torsades de pointes.

Possible side effect

Common: Diarrhea (6%), nausea (6%), abnormal taste (6%), dyspepsia (5%), abdominal pain (4%), headache (3%). Less common: Vomiting, oral moniliasis, tongue discoloration, stomatitis, glossitis, dizziness, insomnia, rash, pruritus. Rare but serious: Clostridium difficile-associated diarrhea, QT prolongation, torsades de pointes, hepatic dysfunction (including hepatitis and cholestatic jaundice), hearing loss (usually reversible), Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylaxis.

Drug interaction

Significant interactions with: CYP3A substrates (increased levels of carbamazepine, colchicine, digoxin, theophylline, warfarin), CYP3A inhibitors (potentiated effects), HIV protease inhibitors (contraindicated with some), statins (increased risk of rhabdomyolysis), verapamil, diltiazem (additive QT prolongation), oral hypoglycemics (potential hypoglycemia), triazolam (increased sedation). Avoid concomitant use with drugs that prolong QT interval. P-glycoprotein substrates may have increased concentrations.

Missed dose

Take the missed dose as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintain the regular dosing schedule. If multiple doses are missed, contact healthcare provider for guidance.

Overdose

Symptoms may include severe nausea, vomiting, diarrhea, and abdominal pain. QT prolongation and torsades de pointes may occur. Hepatic dysfunction and hearing loss have been reported. Treatment is supportive; gastric lavage may be considered if presented soon after ingestion. No specific antidote exists. Hemodialysis does not significantly remove clarithromycin. Monitor ECG for QT prolongation and provide symptomatic treatment.

Storage

Store at room temperature (20-25°C or 68-77°F). Keep container tightly closed. Protect from light and moisture. Keep out of reach of children. Do not use after expiration date. Suspension remains stable for 14 days after reconstitution when stored at room temperature; discard any unused portion after this period.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. The prescribing physician should be consulted for specific recommendations based on individual patient circumstances. Full prescribing information should be reviewed before administration.

Reviews

“Biaxin has been a reliable choice in my practice for respiratory infections, particularly when penicillin allergies limit options. The twice-daily dosing generally supports good adherence.” - Infectious Disease Specialist, 15 years experience

“Effective for sinusitis and bronchitis in most patients. I occasionally see taste disturbance complaints, but this typically resolves after completion of therapy.” - ENT Specialist

“Pediatric suspension formulation allows for accurate dosing in children. Parents appreciate the twice-daily schedule compared to some alternatives.” - Pediatrician

“We use Biaxin in our H. pylori eradication protocols with good success rates. The combination therapy is generally well-tolerated by most patients.” - Gastroenterologist