Фармакодинамика ; Экозитрин - полусинтетический макролидный антибиотик широкого спектра действия. Нарушает синтез белка микроорганизмов (связывается с 50S субъединицей мембраны рибосом микробной клетки). Действует на вне - и внутриклеточно расположенных возбудителей. Активность кларитромицина в отношении большинства следующих микроорганизмов доказана in vitro и в клинической практике - аэробные грамположительные микроорганизмы: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes; аэробные грамотрицательные микроорганизмы: Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, Legionella pneumophila; др. микроорганизмы: Mycoplasma pneumoniae, Chlamydia pneumoniae; микобактерии: Mycobacterium avium complex (MAC) - комплекс, включающий: Mycobacterium avium и Micobacterium intracellulare; Helycobacter pylori.; Бета-лактамазы не влияют на активность кларитромицина.; Активность кларитромицина in vitro - аэробные грамположительные микроорганизмы: Listeria monocytogenes, Streptococcus agalactiae, Streptococci групп C,F,G, Streptococci группы viridans; аэробные грамотрицательные микроорганизмы: Neisseriа gonorrhoeae, Bordetella pertussis, Pasteurella multocida; анаэробные грамположительные микроорганизмы: Сlostridium perfringens, Peptococcus niger, Propionibacterium acnes; анаэробные грамотрицательные микроорганизмы: Bacteroides melaninogenicus; спирохеты: Borrelia burgdorferi, Treponema pallidum; микобактерии: Mycobacterium leprae, Mуcobacterium chelonae, кампилобактерии: Campylobacter jejuni.; Микробиологически активный метаболит кларитромицина - 14-гидроксикларитромицин вдвое более активен, чем исходное соединение по отношению к Haemophilus influenzae. Кларитромицин и его метаболит в сочетании могут оказывать как аддитивное, так и синергическое действие на Haemophilus influenzae in vitro и in vivo, в зависимости от штамма бактерии.; Большинство штаммов стафилококков, устойчивых к метициллину и оксациллину резистентны к кларитромицину. ; Возможно развитие перекрестной резистентности к кларитромицину и другим антибиотикам группы макролидов, а также линкомицину и клиндамицину.
Показания к применению
Взрослым:
Фарингит
Тонзиллит
Острый гайморит
Обострение хронического бронхита
Внебольничная пневмония
Неосложненные инфекции кожи и подкожной клетчатки
Диссеминированная инфекция, вызванная Mycobacterium avium и Mycobacterium intracellulare
— в комбинации с амоксициллином и омепразолом/лансопразолом в виде тройной терапии при инфекциях, вызванных Helicobacter pylori, включая язвенную болезнь двенадцатиперстной кишки.
Детям:
Фарингит
Тонзиллит
Внебольничная пневмония
Острый гайморит
Острый средний отит
Неосложненные инфекции кожи и подкожной клетчатки
Диссеминированная инфекция, вызванная Mycobacterium avium и Mycobacterium intracellulare
Противопоказания
Повышенная чувствительность к кларитромицину, другим антибиотикам группы макролидов, другим компонентам препарата
Тяжелая печеночная недостаточность, протекающая одновременно с почечной недостаточностью
Порфирия
Гипокалиемия
Одновременный прием цизаприда, астемизола, пимозида, терфенадина, эрготамина и других алкалоидов спорыньи
Одновременное применение с ловастатином и симвастатином, с мидазоламом для перорального приема, с колхицином у пациентов с нарушенной функцией почек или печени, принимающих ингибиторы Р-гликопротеина или мощные ингибиторы изофермента CYP3A4
Наличие у пациентов удлинения интервала QT в анамнезе, желудочковой аритмии или желудочковой тахикардии типа "пируэт"
Холестатическая желтуха/гепатит, возникшие при применении кларитромицина (в анамнезе)
Детский возраст до 12 лет (для данной лекарственной формы)
Период лактации (грудного вскармливания)
Непереносимость лактозы или недостаточность лактазы, а также глюкозо-галактозная мальабсорбция
С осторожностью:
Почечная недостаточность средней и тяжелой степени
Печеночная недостаточность средней и тяжелой степени
Миастения gravis
Одновременное применение с лекарственными препаратами, индуцирующими и метаболизирующимися изоферментом CYP3A4, бензодиазепинами (алпразолам, триазолам, мидазолам для в/в применения), антиаритмическими препаратами класса IA и III, блокаторами медленных кальциевых каналов, которые метаболизируются изоферментом CYP3A4
ИБС
Тяжелая сердечная недостаточность
Гипомагниемия; выраженная брадикардия
Применение при беременности и в период грудного вскармливания
Безопасность применения кларитромицина в период беременности не установлена. При беременности, особенно в первый триместр, рекомендуется назначать кларитромицин, если польза от его приема превышает потенциальные риски для плода и/или отсутствует более безопасная терапия альтернативными препаратами. Если беременность наступила во время приема препарата, пациентку следует предупредить о возможных рисках для плода. При необходимости назначения препарата в период лактации следует решить вопрос об отмене грудного вскармливания.
Способ применения и дозы
Препарат принимают внутрь. Таблетки следует проглатывать, не разжевывая, запивая небольшим количеством жидкости.; Взрослым и детям старше 12 лет и с массой тела более 33 кг: при фарингите и тонзиллите, вызванным Streptococcus pyogenes - по 250 мг каждые 12 ч в течение 10 дней; при остром гайморите - по 500 мг каждые 12 ч в течение 14 дней; при обострении хронического бронхита, вызванного Haemophilus influenzae - по 500 мг каждые 12 ч в течение 7-14 дней; вызванного Haemophilus parainfluenzae - по 500 мг каждые 12 ч в течение 7 дней; вызванного Moraxella catarrhalis, Streptococcus pneumoniae - по 250 мг каждые 12 ч в течение 7-14 дней; при внебольничной пневмонии, вызванной Haemophilus influenzae - по 250 мг каждые 12 ч в течение 7 дней; вызванной Streptococcus pneumoniae, Chlamydia pneumoniae, Mycoplasma pneumoniae - пo 250 мг каждые 12 ч в течение 7-14 дней; при неосложненных инфекциях кожи и подкожной клетчатки, вызванных Staphylococcus aureus, Streptococcus pyogenes - по 250 мг каждые 12 ч в течение 7-14 дней.; Для лечения и профилактики инфекций, вызванных Mycobacterium avium, назначают по 500 мг 2 раза/сут. Максимальная суточная доза - 1000 мг. Длительность лечения - 6 мес и более.; С целью эрадикации Helicobacter pylori; Комбинированное лечение тремя препаратами: - кларитромицин - 500 мг, лансопразол - 30 мг и амоксициллин - 1000 мг 2 раза/сут в течение 10-14 дней; - кларитромицин - 500 мг, омепразол - 20 мг и амоксициллин - 1000 мг 2 раза/сут в течение 10 дней.; Комбинированное лечение двумя препаратами: - кларитромицин - 500 мг 3 раза/сут, омепразол - 40 мг/сут в течение 14 дней, с назначением омепразола в течение последующих 14 дней в дозе 20 мг/сут.; Для пациентов с хронической почечной недостаточностью (КК менее 30 мл/мин или концентрации сывороточного креатинина более 3.3 мг/100 мл) дозу снижают в 2 раза, либо в 2 раза увеличивают интервал. Максимальная длительность лечения у пациентов этой группы - 14 дней.
Побочное действие
Со стороны нервной системы: головная боль, головокружение, беспокойство, бессонница, кошмарные сновидения, тремор, судороги, депрессия, дезориентация, галлюцинации, психоз, деперсонализация, спутанность сознания, усиление симптомов миастении gravis, психотические расстройства, парестезия, мания.; Со стороны пищеварительной системы: анорексия, ухудшение аппетита, тошнота, отрыжка, рвота, метеоризм, гастрит, гастралгия, диарея, стоматит, глоссит, кандидоз слизистой оболочки полости рта, изменение цвета языка и зубов, сухость слизистой оболочки полости рта, острый панкреатит, повышение активности печеночных трансаминаз, холестаз, гепатоцеллюлярный и холестатический гепатит, холестатическая желтуха; редко - псевдомембранозный колит, печеночная недостаточность с летальным исходом в основном на фоне тяжелых сопутствующих заболеваний и/или сопутствующей лекарственной терапии, диспепсия, запор.; Со стороны сердечно-сосудистой системы: желудочковая тахикардия, в т.ч. типа "пируэт", трепетание и мерцание желудочков, увеличение интревала QT на ЭКГ.; Со стороны органов чувств: шум, звон в ушах, вертиго, изменение вкуса (дисгевзия), агевзия; в единичных случаях - потеря слуха, проходящая после отмены препарата, нарушение обоняния, аносмия.; Со стороны кожи и мягких тканей: эритразма, акне, рожа.; Со стороны костно-мышечной системы: миалгия, миопатия, боль в грудной клетке.; Со стороны органов кроветворения: редко - тромбоцитопения, (необычные кровотечения, кровоизлияния), агранулоцитоз, тромбоцитоз, удлинение протромбинового времени, повышение уровня МНО.; Со стороны мочевыводящей системы: интерстициальный нефрит, почечная недостаточность.; Лабораторные показатели: лейкопения, нейтропения, эозинофилия, повышение концентрации билирубина в крови гиперкреатининемия, гипогликемия (в т.ч. при одновременном приеме гипогликемических препаратов), изменение цвета мочи.; Аллергические реакции: кожная сыпь, зуд, крапивница, гиперемия кожи, злокачественная экссудативная эритема (синдром Стивенса-Джонсона), токсический эпидермальный некролиз, анафилактические реакции, лекарственная сыпь с эозинофилией и системной симптоматикой (DRESS-синдром), пурпура Шенлейна-Геноха, геморрагии.; Прочие: вторичные инфекции (развитие устойчивости микроорганизмов), интенсивное потоотделение, недомогание, астения, озноб, утомляемость.
Передозировка
Симптомы: абдоминальня боль, тошнота, рвота, диарея.; Лечение: промывание желудка, поддерживающая терапия. Не удаляется при гемо - или перитонеальном диализе.
Особые указания
При наличии хронических заболеваний печени необходимо проводить регулярный контроль активности ферментов в сыворотке крови.; С осторожностью назначают на фоне лекарственных средств, метаболизирующихся печенью (рекомендуется измерять их концентрацию в крови).; В случае совместного назначения с варфарином или другими антикоагулянтами необходимо контролировать протромбиновое время.; При развитии вторичной инфекции должна быть назначена адекватная терапия.; При возникновении во время или после лечения тяжелой диареи следует исключить диагноз псевдомембранозного колита, который требует немедленной отмены препарата и назначения соответствующего лечения.
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250 мг; Вспомогательные вещества: лактулоза - 300 мг, повидон-К25 - 9.1 мг, магния стеарат - 6.5 мг, кремния диоксид коллоидный (аэросил) - 4.33 мг, тальк - 13 мг, полакрилин калия - до 650 мг.; Состав оболочки: гипромеллоза - 9.52 мг, тальк - 1.14 мг, титана диоксид - 5.171 мг, макрогол-4000 - 4.14 мг, краситель азорубин - 0.029 мг."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Фармакодинамика ; Экозитрин - полусинтетический макролидный антибиотик широкого спектра действия. Нарушает синтез белка микроорганизмов (связывается с 50S субъединицей мембраны рибосом микробной клетки). Действует на вне - и внутриклеточно расположенных возбудителей. Активность кларитромицина в отношении большинства следующих микроорганизмов доказана in vitro и в клинической практике - аэробные грамположительные микроорганизмы: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes; аэробные грамотрицательные микроорганизмы: Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, Legionella pneumophila; др. микроорганизмы: Mycoplasma pneumoniae, Chlamydia pneumoniae; микобактерии: Mycobacterium avium complex (MAC) - комплекс, включающий: Mycobacterium avium и Micobacterium intracellulare; Helycobacter pylori.; Бета-лактамазы не влияют на активность кларитромицина.; Активность кларитромицина in vitro - аэробные грамположительные микроорганизмы: Listeria monocytogenes, Streptococcus agalactiae, Streptococci групп C,F,G, Streptococci группы viridans; аэробные грамотрицательные микроорганизмы: Neisseriа gonorrhoeae, Bordetella pertussis, Pasteurella multocida; анаэробные грамположительные микроорганизмы: Сlostridium perfringens, Peptococcus niger, Propionibacterium acnes; анаэробные грамотрицательные микроорганизмы: Bacteroides melaninogenicus; спирохеты: Borrelia burgdorferi, Treponema pallidum; микобактерии: Mycobacterium leprae, Mуcobacterium chelonae, кампилобактерии: Campylobacter jejuni.; Микробиологически активный метаболит кларитромицина - 14-гидроксикларитромицин вдвое более активен, чем исходное соединение по отношению к Haemophilus influenzae. Кларитромицин и его метаболит в сочетании могут оказывать как аддитивное, так и синергическое действие на Haemophilus influenzae in vitro и in vivo, в зависимости от штамма бактерии.; Большинство штаммов стафилококков, устойчивых к метициллину и оксациллину резистентны к кларитромицину. ; Возможно развитие перекрестной резистентности к кларитромицину и другим антибиотикам группы макролидов, а также линкомицину и клиндамицину."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Взрослым:"}},{"type":"list","data":{"style":"unordered","items":["Фарингит","Тонзиллит","Острый гайморит","Обострение хронического бронхита","Внебольничная пневмония","Неосложненные инфекции кожи и подкожной клетчатки","Диссеминированная инфекция, вызванная Mycobacterium avium и Mycobacterium intracellulare"]}},{"type":"paragraph","data":{"text":"— в комбинации с амоксициллином и омепразолом/лансопразолом в виде тройной терапии при инфекциях, вызванных Helicobacter pylori, включая язвенную болезнь двенадцатиперстной кишки."}},{"type":"paragraph","data":{"text":"Детям:"}},{"type":"list","data":{"style":"unordered","items":["Фарингит","Тонзиллит","Внебольничная пневмония","Острый гайморит","Острый средний отит","Неосложненные инфекции кожи и подкожной клетчатки","Диссеминированная инфекция, вызванная Mycobacterium avium и Mycobacterium intracellulare"]}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Повышенная чувствительность к кларитромицину, другим антибиотикам группы макролидов, другим компонентам препарата","Тяжелая печеночная недостаточность, протекающая одновременно с почечной недостаточностью","Порфирия","Гипокалиемия","Одновременный прием цизаприда, астемизола, пимозида, терфенадина, эрготамина и других алкалоидов спорыньи","Одновременное применение с ловастатином и симвастатином, с мидазоламом для перорального приема, с колхицином у пациентов с нарушенной функцией почек или печени, принимающих ингибиторы Р-гликопротеина или мощные ингибиторы изофермента CYP3A4","Наличие у пациентов удлинения интервала QT в анамнезе, желудочковой аритмии или желудочковой тахикардии типа \"пируэт\"","Холестатическая желтуха/гепатит, возникшие при применении кларитромицина (в анамнезе)","Детский возраст до 12 лет (для данной лекарственной формы)","Период лактации (грудного вскармливания)","Непереносимость лактозы или недостаточность лактазы, а также глюкозо-галактозная мальабсорбция"]}},{"type":"paragraph","data":{"text":"С осторожностью:"}},{"type":"list","data":{"style":"unordered","items":["Почечная недостаточность средней и тяжелой степени","Печеночная недостаточность средней и тяжелой степени","Миастения gravis","Одновременное применение с лекарственными препаратами, индуцирующими и метаболизирующимися изоферментом CYP3A4, бензодиазепинами (алпразолам, триазолам, мидазолам для в/в применения), антиаритмическими препаратами класса IA и III, блокаторами медленных кальциевых каналов, которые метаболизируются изоферментом CYP3A4","ИБС","Тяжелая сердечная недостаточность","Гипомагниемия; выраженная брадикардия"]}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Безопасность применения кларитромицина в период беременности не установлена. При беременности, особенно в первый триместр, рекомендуется назначать кларитромицин, если польза от его приема превышает потенциальные риски для плода и/или отсутствует более безопасная терапия альтернативными препаратами. Если беременность наступила во время приема препарата, пациентку следует предупредить о возможных рисках для плода. При необходимости назначения препарата в период лактации следует решить вопрос об отмене грудного вскармливания."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат принимают внутрь. Таблетки следует проглатывать, не разжевывая, запивая небольшим количеством жидкости.; Взрослым и детям старше 12 лет и с массой тела более 33 кг: при фарингите и тонзиллите, вызванным Streptococcus pyogenes - по 250 мг каждые 12 ч в течение 10 дней; при остром гайморите - по 500 мг каждые 12 ч в течение 14 дней; при обострении хронического бронхита, вызванного Haemophilus influenzae - по 500 мг каждые 12 ч в течение 7-14 дней; вызванного Haemophilus parainfluenzae - по 500 мг каждые 12 ч в течение 7 дней; вызванного Moraxella catarrhalis, Streptococcus pneumoniae - по 250 мг каждые 12 ч в течение 7-14 дней; при внебольничной пневмонии, вызванной Haemophilus influenzae - по 250 мг каждые 12 ч в течение 7 дней; вызванной Streptococcus pneumoniae, Chlamydia pneumoniae, Mycoplasma pneumoniae - пo 250 мг каждые 12 ч в течение 7-14 дней; при неосложненных инфекциях кожи и подкожной клетчатки, вызванных Staphylococcus aureus, Streptococcus pyogenes - по 250 мг каждые 12 ч в течение 7-14 дней.; Для лечения и профилактики инфекций, вызванных Mycobacterium avium, назначают по 500 мг 2 раза/сут. Максимальная суточная доза - 1000 мг. Длительность лечения - 6 мес и более.; С целью эрадикации Helicobacter pylori; Комбинированное лечение тремя препаратами: - кларитромицин - 500 мг, лансопразол - 30 мг и амоксициллин - 1000 мг 2 раза/сут в течение 10-14 дней; - кларитромицин - 500 мг, омепразол - 20 мг и амоксициллин - 1000 мг 2 раза/сут в течение 10 дней.; Комбинированное лечение двумя препаратами: - кларитромицин - 500 мг 3 раза/сут, омепразол - 40 мг/сут в течение 14 дней, с назначением омепразола в течение последующих 14 дней в дозе 20 мг/сут.; Для пациентов с хронической почечной недостаточностью (КК менее 30 мл/мин или концентрации сывороточного креатинина более 3.3 мг/100 мл) дозу снижают в 2 раза, либо в 2 раза увеличивают интервал. Максимальная длительность лечения у пациентов этой группы - 14 дней."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны нервной системы: головная боль, головокружение, беспокойство, бессонница, кошмарные сновидения, тремор, судороги, депрессия, дезориентация, галлюцинации, психоз, деперсонализация, спутанность сознания, усиление симптомов миастении gravis, психотические расстройства, парестезия, мания.; Со стороны пищеварительной системы: анорексия, ухудшение аппетита, тошнота, отрыжка, рвота, метеоризм, гастрит, гастралгия, диарея, стоматит, глоссит, кандидоз слизистой оболочки полости рта, изменение цвета языка и зубов, сухость слизистой оболочки полости рта, острый панкреатит, повышение активности печеночных трансаминаз, холестаз, гепатоцеллюлярный и холестатический гепатит, холестатическая желтуха; редко - псевдомембранозный колит, печеночная недостаточность с летальным исходом в основном на фоне тяжелых сопутствующих заболеваний и/или сопутствующей лекарственной терапии, диспепсия, запор.; Со стороны сердечно-сосудистой системы: желудочковая тахикардия, в т.ч. типа \"пируэт\", трепетание и мерцание желудочков, увеличение интревала QT на ЭКГ.; Со стороны органов чувств: шум, звон в ушах, вертиго, изменение вкуса (дисгевзия), агевзия; в единичных случаях - потеря слуха, проходящая после отмены препарата, нарушение обоняния, аносмия.; Со стороны кожи и мягких тканей: эритразма, акне, рожа.; Со стороны костно-мышечной системы: миалгия, миопатия, боль в грудной клетке.; Со стороны органов кроветворения: редко - тромбоцитопения, (необычные кровотечения, кровоизлияния), агранулоцитоз, тромбоцитоз, удлинение протромбинового времени, повышение уровня МНО.; Со стороны мочевыводящей системы: интерстициальный нефрит, почечная недостаточность.; Лабораторные показатели: лейкопения, нейтропения, эозинофилия, повышение концентрации билирубина в крови гиперкреатининемия, гипогликемия (в т.ч. при одновременном приеме гипогликемических препаратов), изменение цвета мочи.; Аллергические реакции: кожная сыпь, зуд, крапивница, гиперемия кожи, злокачественная экссудативная эритема (синдром Стивенса-Джонсона), токсический эпидермальный некролиз, анафилактические реакции, лекарственная сыпь с эозинофилией и системной симптоматикой (DRESS-синдром), пурпура Шенлейна-Геноха, геморрагии.; Прочие: вторичные инфекции (развитие устойчивости микроорганизмов), интенсивное потоотделение, недомогание, астения, озноб, утомляемость."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: абдоминальня боль, тошнота, рвота, диарея.; Лечение: промывание желудка, поддерживающая терапия. Не удаляется при гемо - или перитонеальном диализе."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При наличии хронических заболеваний печени необходимо проводить регулярный контроль активности ферментов в сыворотке крови.; С осторожностью назначают на фоне лекарственных средств, метаболизирующихся печенью (рекомендуется измерять их концентрацию в крови).; В случае совместного назначения с варфарином или другими антикоагулянтами необходимо контролировать протромбиновое время.; При развитии вторичной инфекции должна быть назначена адекватная терапия.; При возникновении во время или после лечения тяжелой диареи следует исключить диагноз псевдомембранозного колита, который требует немедленной отмены препарата и назначения соответствующего лечения."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Фармакодинамика ; Экозитрин - полусинтетический макролидный антибиотик широкого спектра действия. Нарушает синтез белка микроорганизмов (связывается с 50S субъединицей мембраны рибосом микробной клетки). Действует на вне - и внутриклеточно расположенных возбудителей. Активность кларитромицина в отношении большинства следующих микроорганизмов доказана in vitro и в клинической практике - аэробные грамположительные микроорганизмы: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes; аэробные грамотрицательные микроорганизмы: Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, Legionella pneumophila; др. микроорганизмы: Mycoplasma pneumoniae, Chlamydia pneumoniae; микобактерии: Mycobacterium avium complex (MAC) - комплекс, включающий: Mycobacterium avium и Micobacterium intracellulare; Helycobacter pylori.; Бета-лактамазы не влияют на активность кларитромицина.; Активность кларитромицина in vitro - аэробные грамположительные микроорганизмы: Listeria monocytogenes, Streptococcus agalactiae, Streptococci групп C,F,G, Streptococci группы viridans; аэробные грамотрицательные микроорганизмы: Neisseriа gonorrhoeae, Bordetella pertussis, Pasteurella multocida; анаэробные грамположительные микроорганизмы: Сlostridium perfringens, Peptococcus niger, Propionibacterium acnes; анаэробные грамотрицательные микроорганизмы: Bacteroides melaninogenicus; спирохеты: Borrelia burgdorferi, Treponema pallidum; микобактерии: Mycobacterium leprae, Mуcobacterium chelonae, кампилобактерии: Campylobacter jejuni.; Микробиологически активный метаболит кларитромицина - 14-гидроксикларитромицин вдвое более активен, чем исходное соединение по отношению к Haemophilus influenzae. Кларитромицин и его метаболит в сочетании могут оказывать как аддитивное, так и синергическое действие на Haemophilus influenzae in vitro и in vivo, в зависимости от штамма бактерии.; Большинство штаммов стафилококков, устойчивых к метициллину и оксациллину резистентны к кларитромицину. ; Возможно развитие перекрестной резистентности к кларитромицину и другим антибиотикам группы макролидов, а также линкомицину и клиндамицину.","substance":[{"id":192,"title":"Кларитромицин","title_latin":"Clarithromycinum","slug":"klaritromitsin_192"}],"branding":null,"valid_for_quick_buy":false,"is_available_to_delivery":false,"comments":null,"image_alt":"Экозитрин - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/1069/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/1069/share_default/"}},"diseases":[{"id":"2190","title":"Хронический фарингит","slug":"2190-hronicheskiy_faringit"},{"id":"2455","title":"Инфекция, 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