Drug utilization of clarithromycin for gastrointestinal disease treatment

Table 1 Details of prescriptions of the two clarithromycin products

	Clarithromycin
	Sustained-release	Immediate release
Total number of prescriptions	949	197
Number of prescriptions for alimentary disease	164	110
Mean age (range) yr	45.9 (18-82)
Male:Female	137:137
Number of prescriptions for anti-H pylori therapy	159	96
Triple therapy	151	83
PPI/Clarithromycin/Amoxicillin	43	58
PPI/Clarithromycin/Furazolidone	44	21
PPI/Clarithromycin/Levofloxacin	63	1
PPI/Clarithromycin/Metronidazole	1	1
PPI/Clarithromycin/Tinidazole	0	2
Quadruple therapy	5	6
PPI/Bismuth/Amoxicillin/Clarithromycin	0	2
PPI/Bismuth/ Furazolidone/Clarithromycin	1	3
PPI/Bismuth/Levofloxacin/Clarithromycin	4	1
Dual therapy	3	7
Clarithromycin/PPI	2	7
Clarithromycin/Ranitidine bismuth citrate	1	0

PPI: Proton pump inhibitor.

Table 2 Diagnoses of patients on clarithromycin-based therapy

Diagnoses	Clarithromycin
	SR	IR
Chronic gastritis	90	87
Peptic ulcer	40	5
Duodenal ulcer	9	5
Gastro-oesophageal reflux disease	5	1
Chronic gastritis, H pylori infection	4	3
Gastric ulcer	1	4
Chronic gastritis, Gastric ulcer	2	1
Gastro-oesophageal reflux disease, Gastric ulcer	1
H pylori infection	2
Chronic gastritis, Peptic ulcer	1	3
Peptic ulcer, H pylori infection		1
Mesenteric lymphadenitis	7
Abdominal pain of unknown origin	2

SR: Sustained-release; IR: Immediate release.

Table 3 Concomitant drugs used in clarithromycin-based triple therapy

Comedicated drugs	Clarithromycin
	SR	IR
PPI
Omeprazole	17	6
Lansoprazole	68	6
Pantoprazole	30	66
Esomeprazole magnesium	15	11
Rebeprazole	23	21
Antibiotics
Amoxicillin	38	63
Furazolidone	47	24
Levofloxacin	67	2
Metronidazole	1	1
Tinidazole	0	13
Amoxicillin/clavulanate potassium	5	0

SR: Sustained-release; IR: Immediate release.

Table 4 CYP3A based clinical significant drug interactions with clarithromycin

Concurrent medications primarily metabolized by CYP3A	Clarithromycin		References
	SR	IR
Alprazolam and zolpidem	1		[6,7]
Midazolam	1		[6,8]
Amlodipine	1	2	[9]
Levoamlodipine		1
Nifedipine		1	[10]
Carbamazepine		1	[11]
Nifedipine, clopidogrel and atorvastatin		1	[10,12-14]
Amlodipine and ergoloid mesylate sustained release capsules		1	[9,15]
Prednisone		1	[16]

SR: Sustained-release; IR: Immediate release.