Clarithromycin ® is a fourteen-membered macrolide that is a semi-synthetic derivative.

Clarithromycin ® binds to the 50S subunit of the bacterial cell ribosome membrane and inhibits protein biosynthesis. Active against intracellular pathogens.

The drug is superior to erythromycin in pharmacokinetic and antibacterial properties. The antibiotic is stable in an acidic environment. When taken orally, it is absorbed fairly quickly. Cmax reached in about 2.5 hours.
Clarithromycin is prescribed for infectious lesions of the upper and lower respiratory tract, non-epithelial extraskeletal tissues, skin, dental system. Clarithromycin ® is taken for mycobacterial infections and is prescribed to treat infectious processes in patients with immunodeficiency virus.

The drug is used in the first line of Helicobacter pylori eradication. Antibiotic causes side effects nervous system, digestive tract and hematopoietic organs. Original drug Clarithromycin affects the sense organs. The antibiotic is contraindicated in children under 12 years of age and in patients with hypersensitivity to at least one component in the composition.

Binoclair ®

It is active against gram + (staphylococci, streptococci), gram- (hemophilic bacillus, hemophilus, gonococcus, legionella pneumophila, campylobacter jejuni) foreign agents, as well as anaerobes (bacteroids, clostridia, peptostreptococci). Rapidly absorbed from the gastrointestinal tract. Bioavailability reaches 50 percent. The half-life is about 4 hours.

Clubax ®

It is a semi-synthetic macrolide of the latest generation. Klabaks is effective in the treatment of tonsillitis, pneumonia, furunculosis. The antibiotic is taken at 250 mg twice a day, with severe infections, the dosage is increased by 2 times. The course of treatment is from 1 to 2 weeks.

Clubax OD ®

Main active substance- clarithromycin. The drug is effective for infections of the respiratory tract, ENT organs, skin, urinary tract, gastrointestinal tract, etc.

Klabax OD ® is forbidden to be taken simultaneously with some antihistamines and serotonergic drugs, as well as antipsychotics. The drug is contraindicated in severe pathologies of the kidneys and liver, as well as in patients with porphyrin disease.

Clarkact ®

It also affects protein synthesis of pathogenic microorganisms. It is active against all mycobacteria, except for Koch's Wands.

Klarbakt ® is absorbed quickly. Eating slows down absorption. Prolonged antibiotic therapy is fraught with the development of superinfection (candidiasis). The antibiotic penetrates into women's milk, so the treatment of lactating women is possible with the abolition of breastfeeding.

Clarithrosin ®

Available in the form of tablets yellow color film-coated. The medication is taken orally, regardless of food intake.

Clarithrosin ® is prescribed for inflammation of the bronchial mucosa, lymphoid tissue of the pharynx, palatine tonsils, paranasal sinuses, nosocomial pneumonia, hair follicle and infections oral cavity. The drug is taken to prevent relapse peptic ulcer.

Klacid ®

Lecoclar ®

Lecoclar ® should not be prescribed to children under six months of age, as there is insufficient data on its efficacy and safety at this time. The antibiotic is contraindicated in patients with a history of hepatitis.

A derivative of erythromycin.

Azithromycin - chemical compound

Chemically, azithromycin is 9-deoxo-9a-aza-9a-methyl-9a-homoerythromycin A (also as dihydrate). The empirical formula of azithromycin is C 38 H 72 N 2 O 12 . Azithromycin is a white or almost white crystalline powder, readily soluble in chloroform and 96% alcohol, practically insoluble in water. The molecular weight of azithromycin is 827.995

It belongs to the subclass of azalides, which differ from other macrolides in that a nitrogen atom is added to the 14-membered lactone ring (top-left in the diagram of the azithromycin molecule).

Azithromycin - medicinal product

Azithromycin - international generic name(INN) medicinal product. According to the pharmacological index, azithromycin belongs to the group "Macrolides and azalides". According to the ATC, azithromycin is included in the group "J01 Antibacterials for systemic use" and has the code J01FA10.

Azithromycin is also a trade name for the drug.

Indications for the use of azithromycin

infections upper divisions respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, otitis media), scarlet fever, infections of the lower respiratory tract (bacterial pneumonia, bronchitis), infections of the skin and soft tissues, infections of the genitourinary tract (Instruction for the drug).

Azithromycin use and dosage

Azithromycin is taken once a day, always one hour before or two hours after a meal. Adults with infections of the upper and lower respiratory tract, with infections of the skin and soft tissues are prescribed 0.5 g per day for 3 days, with uncomplicated diseases of the genitourinary tract (uncomplicated urethritis or cervicitis) - once 2 tablets of 0.5 g. Children are prescribed at the rate of 10 mg per kg of body weight 1 time per day for 3 days or on the first day - 10 mg per kg of body weight, then 4 days - 5-10 mg per kg of body weight per day for 3 days (course dose - 30 mg per kg of body weight).

Azithromysin in powder is dissolved in water (in accordance with the instructions in the instructions for the drug). Shake well before use and take once orally. Azithromysin should be taken on an empty stomach, at least one hour before or two hours after a meal. The dose is calculated similarly to the figures above.

Azithromycin in Helicobacter pylori eradication schemes

Azithromycin is included by WHO in the first line of active against Helicobacter pylori drugs (Teplova N.V., Teplova N.N.), however, it is not mentioned in the “Standards for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases (fourth Moscow agreement)” as part of eradication schemes Helicobacter pylori.

Many reputable gastroenterologists recommend the use of azithromycin, arguing that macrolides, mainly clarithromycin, are widely used in anti-Helicobacter therapy regimens and that, despite the high efficiency, clarithromycin is expensive and causes a number of adverse reactions(diarrhea), which impair treatment tolerance. As a result, the question is raised of the search for macrolides that would not be inferior to clarithromycin in terms of effectiveness, but would cost less and give less side effects. One of these drugs is azithromycin (Teplova N.V., Teplova N.N.).

Azithromycin is a good example to illustrate the possibilities of optimizing the triple therapy eradication regimen. Macrolide antibiotics given in triple regimens, mainly clarithromycin, are most effective. Azithromycin has been tried for a number of years as one of the possible components of therapy, but in early studies a relatively low dose of the drug was used. An increase in the course dose to 3 g led to an increase in the effectiveness of the standard seven-day triple regimen based on a proton pump inhibitor to the required level of more than 80%. At the same time, the undoubted advantage is that as part of a weekly course, the full dose of azithromycin is taken for three days, and once a day. This is convenient for the patient and reduces the percentage of side effects. In addition, in Russia the cost of azithromycin is lower than other modern macrolides (Lapina T.L., Ivashkin V.T.).

All drugs of the macrolide group are characterized by the development of cross-resistance of strains in vitro, but not all macrolides can equally form such resistance in Helicobacter pylori in vivo, since this also depends on the ability of the drug to accumulate in the mucosal layer. Since clarithromycin quickly reaches inhibitory concentrations on the surface of the gastric mucosa, after a course of treatment, 2/3 of non-killed strains Helicobacter pylori become resistant to it. This cannot be said about azithromycin - it has a low eradication efficiency (62%), but secondary resistance develops only in 23% of cases (Kornienko E.A., Parolova N.I.).

Monotherapy Helicobacter pylori azithromycin is not allowed. Azithromycin is not used in eradication Helicobacter pylori outside special schemes, without drugs that reduce the acidity of the stomach. Azithromycin is also not used to treat gastric and duodenal ulcers and gastritis in the absence of Helicobacter pylori in a patient.

Professional medical publications concerning the use of azithromycin in the eradication of Helicobacter pylori

• Teplova N.V., Teplova N.N. Antihelicobacter peptic ulcer therapy with azithromycin and amoxicillin // RMJ. Diseases of the digestive system. - 2004. - v. 6. - No. 2. - 68-70.


• Rusova T.V., Selezneva E.V., Glazova T.G. Clinical examination of children with chronic gastroduodenitis // Questions of children's dietology, 2015, vol. 13, no. 1, pp. 62-69.

On the site in the literature catalog there is a section "Antibiotics used in the treatment of diseases of the gastrointestinal tract", containing articles on the use of antimicrobial agents in the treatment of diseases of the digestive tract.

Azithromycin as a prokinetic

Azithromycin, like other macrolides, is a motilin receptor agonist and therefore has prokinetic effects and as such is considered as a drug that affects the motility of the gastrointestinal tract. It has been shown that in GERD patients with small hiatal hernias (<3 см) приём азитромицина уменьшает размер грыжи, увеличивает период её стабилизации и способствует перемещению «кислотного кармана» в более дистальное положение по сравнению с плацебо. При этом наблюдалось снижение интенсивность кислотного рефлюкса (с 38% до 17%), тогда как общее количество рефлюксов не изменилось. У больных с большими грыжами (≥ 3 см) эти эффекты не наблюдались (Бордин Д.С.). Применение в качестве прокинетика при функциональной диспепсии не показано в связи с «нефизиологичным ускорением опорожнения желудка» (

Clarithromycin and Azithromycin are antibacterial drugs belonging to the macrolide class. They have a wide spectrum of activity. They are used to treat infectious diseases - tuberculosis, mycoplasmosis, Helicobacter-associated gastritis and ulcers. duodenum.

Characteristics of Clarithromycin

An antibacterial drug related to 14-membered macrolides. Stops the reproduction of pathogens, i.e. has a bacteriostatic effect. Suppresses the formation of proteins in microbial cells by binding to the 50S subunit of ribosomes.

It has a wide spectrum of activity, including gram-positive and gram-negative bacteria. Suppresses the reproduction of streptococci, incl. pyogenic, staphylococci, diphtheria, hemophilic bacillus, listeria, moraxella, meningococci, gonococci, whooping cough pathogen, borreliosis, helicobacter, campylobacter, propionic acid bacteria. It is also effective against Mycobacterium tuberculosis, paratuberculosis. It is active against intracellular microorganisms - mycoplasmas, ureaplasmas, chlamydia, legionella, protists - toxoplasma.

Acts on anaerobes - peptococci, clostridium perfringens.

It is used to treat respiratory diseases caused by Pfeiffer's bacillus, Mycobacterium tuberculosis, chlamydia and mycoplasma pneumonia, genital infections, including soft chancre. As part of complex therapy, it is used to treat peptic ulcer of the stomach and duodenum associated with Helicobacter pylori.

6-O-methylerythromycin is prescribed for staphylococcal bronchitis, tonsillitis, streptococcal tonsillitis.

Pharmacokinetics. The drug is absorbed from the intestine quickly, food intake slows down the absorption process. Bioavailability is 50%. When taken on an empty stomach, the maximum concentration in the bloodstream is reached within 2-3 hours. Being absorbed into the bloodstream, it binds to plasma proteins, which transport it to the tissues. 20% of the active substance, passing through the liver, is oxidized, turning into hydroxyclarithromycin, which has an antibacterial effect on Haemophilus influenzae, the causative agent of infection of the respiratory system.

The therapeutic concentration of clarithromycin and its active metabolite remains in the bloodstream for about 2-3 days. The substance penetrates well into body fluids, lungs, skin and other soft tissues.

It is excreted through the urinary system and intestines with bile. 20-40% leaves the body unchanged through the kidneys, 10% of the drug is excreted in the form of hydroxyclarithromycin in the urine.

Contraindications: taking Cisapride, Terfenadine, Astemizol, Pimozide - the risk of prolongation of the QT interval and cardiac arrhythmias, porphyria, macrolide intolerance increases. During pregnancy and lactation, it is used in case of a high risk associated with infections that exceeds the harm of the drug to the fetus or child.

Side effects: vertigo, tinnitus, insomnia, taste perversion, hallucinations, anorexia, transient deafness, jaundice, elevated transaminase levels, nausea, vomiting, diarrhea, bitter taste in the mouth, decreased white blood cell count, thrombocytopenia, exudative erythema.

Pseudomembranous colitis rarely develops, because. there is activity against anaerobes.

Interaction: enhances the vasospastic effect of Ergotamine, increases the concentration in the bloodstream of indirect anticoagulants (monitoring of coagulogram parameters is necessary), benzodiazepines, digitalis and ergot alkaloids.

Simultaneous use with statins increases the risk of their side effect - skeletal muscle necrosis.

Ketoconazole, Fluconazole increase the concentration of macrolide in the bloodstream. 6-O-methylerythromycin increases the plasma concentration of antisecretory agents - H2-histamine blockers, PPIs.

Characteristics of Azithromycin

It is a 15-membered macrolide. It has a bacteriostatic effect, inhibiting the synthesis of microbial protein on ribosomes. In high concentrations, it exhibits a bactericidal effect.

Affects a wide range of gram-positive and gram-negative microorganisms. It is active against viridescent streptococci, streptococci that cause pneumonia, tonsillitis, staphylococci, the causative agent of whooping cough and parapertussis, campylobacter, meningococcus, gonococcus, spirochetes (borrelia, pale treponema). Suppresses the development of anaerobes - bacteroids, peptostreptococci, clostridia of the perfringens species.

It is active against gardnerella, chlamydia, mycoplasmas, legionella, mycobacterium tuberculosis.

It is used to treat sexual infections - mycoplasmosis, ureaplasmosis, chlamydia, syphilis, gardnerellosis. It is prescribed for the treatment of mycoplasma and chlamydial infections of the bronchi and lungs.

Pharmacokinetics. Absorbed from the intestine quickly. Bioavailability - 37%. Once in the blood, the active substance binds to transporter proteins that carry it to the tissues. Penetrates into soft tissues, also spreads by neutrophils, macrophages.

Therapeutic concentration is maintained for 5-7 days after the last dose of the drug. Eating affects the maximum concentration: after the use of capsules - decreases, suspensions, tablets - increases.

Half is excreted by the liver through bile unchanged, 6% - through the kidneys.

Contraindications: severe renal, hepatic insufficiency, allergy to macrolides, age up to 12 years.

What is better than Clarithromycin and Azithromycin?

Similarities

Show bacteriostatic effect, bactericidal in high doses. Active in intracellular infections, tuberculosis, helicobacteriosis.

Differences

Bioavailability - 50% versus 37%. The half-life is 2-3 days versus 5-7 days. Activity against Pseudomonas aeruginosa is more pronounced in Sumamed. The last medicine is available in the following forms - suspensions, capsules, tablets.

Azithromycin, by international agreement, is used to treat genital infections, Clarithromycin is used to treat stomach ulcers and tuberculosis, although both antibiotics are active against these infections.

Azithromycin: effectiveness, side effects, form, dosage, cheap analogues

Quickly about medicines. Clarithromycin

What is cheaper?

The price of antibiotics ranges from 100 rubles. per pack of 5-6 capsules. The difference is insignificant.

Clarithromycin and Azithromycin are two antibacterial agents from the macrolide category. Effective against most types of pathogens, often prescribed by doctors. Therefore, it is difficult for patients to make a decision about which drug to choose for treatment.

Clarithromycin: description of the remedy

Clarithromycin is sold in the form of tablets and capsules. Active substance - clarithromycin- is contained in a concentration of 250 or 500 mg. Also present in the preparation are pregelatinized starch, microcrystalline cellulose, croscarmellose sodium, stearic acid, sodium stearyl fumarate and silicon dioxide.

The protective shell consists of hypromellose, E1200, macrogol 3350, E172 and titanium dioxide. Tablets and capsules in the amount of 7 or 10 pieces are packaged in plates and packed in cardboard boxes.

Clarithromycin is treated with:

• Pneumonia.
• Sinusitis.
• Erysipelas.
• Bronchitis.
• Pharyngitis.
• Folliculitis.
• Otitis.
• Microbacterial infections caused by the activity of Mycobacterium intracellulare, avium, chelonae, kansasii, fortuitum.

The therapeutic effect is achieved due to the fact that clarithromycin binds to the 50s subunit of bacterial ribosomes and blocks protein production. As a result, pathogens die. The drug acts on aerobic, anaerobic microorganisms.

It is forbidden to take medication when:

1. His intolerance.
2. Simultaneous use of ergot derivatives, pimozide, terfenadine, cisapride, astemizole (there is a risk of developing arrhythmias, severe renal and hepatic disorders).
3. Carrying a child.
4. Ages 1-12 years old.
5. Breastfeeding baby.

Children 12 years of age and older and adults Clarithromycin should be taken twice a day, 250 mg. In severe cases, doubling the dose is allowed. The course of treatment varies from 5 to 14 days. With damage to the liver and kidneys, the dose is adjusted.

During treatment, the patient may experience side effects:

• Change in taste.
• Hives.
• Nausea.
• Anaphylactic shock.
• Intestinal disorder.
• Stomatitis.
• Pseudomembranous colitis.
• Insomnia.
• Dizziness.
• Disorientation.
• Depersonalization.
• Candidiasis.

Azithromycin: description of the remedy

Azithromycin is available in tablet and capsule forms. Active ingredient - azithromycin- is contained in an amount of 250, 125 or 500 mg. Additionally, the antibiotic contains magnesium stearate, sodium lauryl sulfate and lactose.

A medication is prescribed for the treatment of infectious pathologies provoked by pathogens sensitive to azithromycin:

• Acute tonsillitis.
• Colpitis.
• Chronic bronchitis.
• Otitis.
• Faces.
• Urethritis.
• Pharyngitis.
• Cervicitis.
• sinusitis.

The therapeutic effect is achieved due to the fact that azithromycin binds to the 50s subunit of ribosomes and begins to inhibit peptide translocase, protein biosynthesis. This leads to a slowdown in growth, cessation of bacterial reproduction and their rapid death.

Antibiotics should not be used for:

1. Pronounced violations of the functioning of the liver.
2. Hypersensitivity.
3. Breastfeeding.
4. Aged 1-5 years.
5. Renal failure.
6. First trimester of pregnancy.

In the second and third trimesters, the drug is allowed to drink only if the intended benefit to the woman is greater than the potential risk to the embryo.

Drink tablets an hour before meals once a day. For adults in the first days of treatment, the dose is 500 mg, then take 250 mg. For children, the drug is selected taking into account body weight: 10 mg of antibiotic is taken per kilogram. A three-day course of treatment is recommended.

During therapy, side effects are possible:

• Pain in the epigastrium.
• Tachycardia.
• Quincke's edema.
• Candidiasis.
• Change in taste.
• Constipation.
• Rash on the epidermis.
• Anorexia.
• Conjunctivitis.
• Sleep disturbance.
• Neurosis.

Comparison: in what cases, which tool is better to use

Clarithromycin and Azithromycin are two effective macrolide antibiotics that are available in tablet and capsule forms. The bioavailability of Azithromycin is two times lower than that of Clarithromycin. But this drug rarely causes side effects, it is considered safer. Therefore, it is allowed to be taken by children from the age of 5 and pregnant women, starting from the second trimester. The course of treatment is shorter.

Clarithromycin is more active against diseases caused by Helicobacter pylori. Therefore, with gastritis and peptic ulcer, this antibiotic should be chosen. Also, the drug is superior in action to Azithromycin in the treatment of pathologies that appeared against the background of infection with pneumococci, streptococci, Staphylococcus aureus, chlamydia and legionella. In relation to mycoplasmas, it acts worse.

Azithromycin is more effective in terms of diseases provoked by enterobacteria, Pseudomonas aeruginosa. This drug is more convenient to use: it is enough to take it once a day. It is excreted from the body longer than Clarithromycin.

Unlike Azithromycin, Clarithromycin has immunostimulating and anti-inflammatory properties. Therefore, it is better to use it in the treatment of chronic infectious pathologies.

Antibiotic therapy is often given to patients when other medications fail to control the disease. Drugs such as Clarithromycin and Azithromycin are able to quickly and effectively cope with a variety of bacterial infectious diseases. They have some similarities, but there are also differences.

The medicine is sold in the form of capsules or tablets. In the package you can buy 7, 10 or 14 pieces of both one and the other. The product contains the main active ingredient clarithromycin, through which a positive result is achieved. In addition to it, the composition includes auxiliary substances such as starch, sodium lauryl sulfate, low molecular weight PVP, colloidal silicon dioxide and MCC. The compositions of tablets and capsules differ slightly precisely in the number and composition of auxiliary components.

The drug is indicated in the presence of the following pathological conditions:

• Infectious diseases of the respiratory tract.
• ENT infections.
• Diseases caused by microbacteria.
• Skin infections.
• A person has Helicobacter pylori.

There are a number of contraindications in which the use of the drug is prohibited. These include:

1. Pregnancy.
2. Natural feeding.
3. Sensitivity to components.
4. Children's age up to 12 years.
5. Simultaneous use of drugs such as cisapride, ergot derivatives, pimozide and terfenadine.

When taking this antibiotic, some patients note the appearance of unpleasant side effects. They usually go away after treatment ends. Among them:

• Visual disturbances.
• Bloating, nausea.
• Chair disorder.
• Noise in ears.
• allergic manifestations.
• Headache.

In some cases, there may be resistance to microorganisms. This phenomenon usually occurs with prolonged or improper use of drugs.

An antibiotic is taken orally with a sufficient amount of water. In this case, the course of treatment usually lasts from a week to two weeks. The dosage is regulated by the attending physician.

The drug is sold from pharmacies by prescription. The approximate cost varies within 150 rubles per package. The amount of the active ingredient on sale can be found in 250 or 500 mg.

The medicine belongs to antibacterial agents. Sold in pharmacies in the form of tablets or powder for solution (suspension). They can be found in the sale of 3 or 6 pieces. There is also a format in the form of capsules of 6 pieces per pack. The powder is sold in 20 grams with different content of the active ingredient.

The main active ingredient in the composition is azithromycin dihydrate. It is due to it that the desired result is achieved. The dosage in tablets is available in 250 or 500 mg. In addition to the main substance, the composition includes auxiliary substances, such as macrogol, starch, lactose, croscarmellose sodium, potassium polacrilin, hypromelose, silicon dioxide, as well as additives E172 and E171.

The powder contains either 15, or 30, or 75 mg of the main active substance per 1 g of powder. The content of additional substances may vary slightly, depending on the format of the sale of the drug.

The drug is indicated in the presence of the following pathologies:

• Acute bronchitis, tonsillitis, sinusitis.
• Tonsillitis, pharyngitis.
• Acne of severe severity.
• Infections like chlamydia.
• Scarlet fever.
• Helicobacter.
• Borreliosis.

There are contraindications for which it is not recommended to take this antibiotic. These include:

1. Children's age at which the weight of the child does not reach 5 kg (for the format in the form of a suspension).
2. Children's age, when the child's weight is less than 45 kg (for the form of tablets).
3. Severe diseases of the liver and kidneys.
4. Pregnancy period.
5. Breast-feeding.

In some cases, patients report the appearance of side effects. Among them, the most common are:

• Dryness of mucous membranes.
• Anorexia.
• allergic manifestations.
• Dizziness, headache.
• Sleep disorders.
• Violation of vision.
• Sensation of a rush of blood to the face.
• Stomach ache.
• Chair disorders.
• Pain in the joints.

The drug is taken orally with water. In the treatment of children, a powder is used, from which suspensions are made (for young children). Children weighing more than 45 kg can already take other medication formats.

The medicine can be found in pharmacies and purchased by prescription. Estimated cost varies 150 rubles for a pack of pills.

Drug Similarities

Both are aimed at treating the same pathologies. They are antibiotics and are quite successful in treating many infections caused by bacteria.

On sale you can find both drugs in the same formats. Their cost is about the same.

Comparison and differences

Both means are antibiotics but they contain different active substances. In addition, Azithromycin is available in powder form for suspension, while Clarithromycin is only available in capsule or tablet form. You can buy them in packs of 10, 7 or 14. And the first is sold in tablets of 3 or 6 pieces, in capsules - 6 pieces each. The composition of auxiliary components also differs.

What's better

Two drugs target treatment of the same diseases. But it is believed that Azithromycin causes fewer side effects than Clarithromycin. Although they belong to the same group. It can be taken by children from 5 years old and in some cases even by pregnant women, although doctors often play it safe and prescribe other, more gentle remedies.

The course of treatment with Clarithromycin is somewhat longer than with the first remedy. In addition, it is considered more effective for the treatment of Helicobacter, therefore, in diseases of the stomach and duodenum, doctors often prescribe it.

Azithromycin copes well with streptococci, Staphylococcus aureus and other similar microorganisms, so specialists often use it to treat diseases caused by these microorganisms.