Biaxin (clarithromycin) is a advanced-generation macrolide antibiotic prescribed for the treatment of a wide spectrum of bacterial infections. Its formulation is designed to target both common and atypical pathogens, offering healthcare providers a reliable therapeutic option for respiratory, skin, and systemic infections. The medication works by inhibiting bacterial protein synthesis, effectively halting proliferation and facilitating eradication. Biaxin is available in both immediate and extended-release formulations, allowing for tailored treatment regimens based on infection severity and patient-specific factors.

Features

• Active ingredient: Clarithromycin
• Available forms: Tablets (250 mg, 500 mg), extended-release tablets (500 mg), oral suspension
• Drug class: Macrolide antibiotic
• Mechanism: Binds to the 50S ribosomal subunit, inhibiting bacterial protein synthesis
• Spectrum: Effective against Gram-positive, some Gram-negative, and atypical bacteria
• Administration: Oral, with or without food (though consistency is recommended)

Benefits

• Effectively treats respiratory tract infections including pneumonia, bronchitis, and sinusitis
• Targets skin and soft tissue infections caused by susceptible Staphylococcus and Streptococcus species
• Used in combination therapy for Helicobacter pylori eradication to reduce ulcer recurrence
• Extended-release formulation allows for convenient once-daily dosing, improving adherence
• Demonstrates good tissue penetration, reaching therapeutic concentrations at infection sites
• Suitable for both adult and pediatric populations (with appropriate formulation adjustments)

Common use

Biaxin is commonly prescribed for bacterial infections such as acute exacerbation of chronic bronchitis, community-acquired pneumonia, acute maxillary sinusitis, pharyngitis, tonsillitis, and uncomplicated skin and skin structure infections. It is also indicated for disseminated mycobacterial infections and, in combination with other agents, for the eradication of Helicobacter pylori to reduce the risk of duodenal ulcer recurrence. Off-label uses may include treatment of Lyme disease, pertussis, and certain sexually transmitted infections, though these require careful clinical evaluation.

Dosage and direction

Dosage varies based on infection type, severity, patient age, renal function, and formulation. For most adult infections: 250–500 mg orally every 12 hours for 7–14 days. For H. pylori eradication: 500 mg twice daily in combination with amoxicillin and a proton pump inhibitor for 10–14 days. Pediatric dosing is weight-based: 7.5 mg/kg every 12 hours. Extended-release tablets (Biaxin XL) are dosed as 1000 mg (two 500 mg tablets) once daily with food. Take with a full glass of water; may be taken with or without food, but consistency minimizes variability in absorption. Complete the full course even if symptoms improve.

Precautions

Inform your healthcare provider of any history of liver or kidney disease, myasthenia gravis, or electrolyte imbalances. Use with caution in patients with known QT prolongation or those taking drugs that prolong the QT interval. Avoid excessive sunlight exposure; Biaxin may increase photosensitivity. Monitor for signs of superinfection (e.g., oral thrush, vaginal yeast infection). Not recommended during pregnancy unless clearly needed (Pregnancy Category C). Use in nursing mothers only if potential benefit justifies potential risk. Geriatric patients may require dosage adjustment based on renal function.

Contraindications

Biaxin is contraindicated in patients with known hypersensitivity to clarithromycin, other macrolides, or any component of the formulation. Concomitant use with cisapride, pimozide, astemizole, terfenadine, ergotamine, or dihydroergotamine is contraindicated due to risk of serious cardiac events. Avoid use in patients with history of cholestatic jaundice/hepatic dysfunction associated with prior clarithromycin use. Do not use in patients with known hypokalemia or receiving drugs that significantly prolong QT interval.

Possible side effect

Common side effects include diarrhea, nausea, abnormal taste, dyspepsia, abdominal pain, and headache. Less frequently, vomiting, glossitis, stomatitis, and oral candidiasis may occur. Serious side effects requiring immediate medical attention include severe diarrhea (possibly Clostridium difficile-associated), hepatotoxicity (jaundice, dark urine), QT prolongation, hearing loss, and severe skin reactions. Allergic reactions ranging from rash to anaphylaxis may occur. Pseudomembranous colitis has been reported with nearly all antibacterial agents.

Drug interaction

Biaxin is a strong CYP3A4 inhibitor and interacts with numerous medications. Significant interactions include: increased levels of simvastatin, lovastatin (risk of rhabdomyolysis); colchicine (risk of toxicity); warfarin (increased INR); carbamazepine, phenytoin (increased levels); sildenafil (increased exposure); and many antipsychotics/antidepressants. Concurrent use with statins, benzodiazepines, calcium channel blockers, and immunosuppressants like cyclosporine requires close monitoring and potential dosage adjustment. Avoid concomitant use with other QT-prolonging agents.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to catch up. Maintaining consistent blood levels is important for efficacy, but a single missed dose is generally not critical; resume the regular dosing schedule. If multiple doses are missed, contact your healthcare provider for guidance.

Overdose

Symptoms of overdose may include severe nausea, vomiting, diarrhea, and abdominal pain. Hepatic dysfunction and hearing loss have been reported. QT prolongation and arrhythmias are possible in significant overdose. There is no specific antidote; treatment is supportive and symptomatic. Gastric lavage may be considered if presented soon after ingestion. Maintain hydration and electrolyte balance. Hemodialysis does not significantly remove clarithromycin. Contact a poison control center or seek emergency medical attention immediately.

Storage

Store at room temperature (20–25°C or 68–77°F); excursions permitted to 15–30°C (59–86°F). Keep the container tightly closed and protect from light and moisture. Do not store in the bathroom. Keep oral suspension tightly closed and discard any unused portion after 14 days. Keep all medications out of reach of children and pets. Do not flush medications; dispose of unused medication through a medicine take-back program.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Do not disregard professional medical advice or delay in seeking it because of something you have read here. Individual patient responses to medication may vary.

Reviews

Clinical studies and post-marketing surveillance demonstrate Biaxin’s efficacy in treating indicated infections, with high bacterial eradication rates and generally favorable tolerability. Healthcare providers often note its utility in respiratory infections and H. pylori regimens. Common patient-reported feedback includes effectiveness in resolving symptoms, though gastrointestinal side effects are frequently mentioned. The extended-release formulation is appreciated for dosing convenience. As with all antibiotics, resistance patterns should guide use. Always consult prescriber reviews and current clinical guidelines for context-specific application.