2016 Treatments for Acid-Peptic Diseases

Macrolides

Selection Strategy

  1. Know efficacy vs. the bug:

CLARITHROMYCIN vs. azithromycin:

  1. Identify route of administration: no critical differences within this class

  2. Acid stability is preferred à CLARITHROMYCIN is more stable than erythromycin

  3. Increase patient compliance:

Azithromycin and CLARITHROMYCIN vs. erythromycin:

  • decreased dosing (H. pylori regimens are complicated and long)
  • decreased GI effects (anorexia, nausea, vomiting, diarrhea; stimulation of gut motility)
  • azithromycin has decreased drug interactions compared to the other 2 drugs (no CYP450 inactivation)
CLARITHROMYCIN is the macrolide antibiotic of choice for H. pylori treatment (azithromycin and erythromycin should not be substituted).  CLARITHROMYCIN has a substantially lower MIC90, is more acid stable and has fewer side effects.
Critical facts icon

MECHANISM OF ACTION and UNIQUE TOXICITY:

Email: Dr. Janet Fitzakerley | ©2016 University of Minnesota Medical School Duluth Campus | Last modified: 7-jan-16 8:27 PM