Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Important information
  
                  
- For administration by intravenous infusion only
 
- There are important interactions with numerous drugs e.g. statins - check current BNF
 
- May cause QTc prolongation
 
- See under 'Dose' for adjustments required in renal impairment
 
- Consider intravenous to oral switch as soon as possible as excellent bioavailability - use same dose orally as intravenously
 
      
  
        Available preparations
  
                  Klacid 500mg vial
Clarithromycin 500mg vial
      
  
        Reconstitution
  
                  Water for injection
Dilute further prior to administration
      
  
        Infusion fluids
  
                  Sodium chloride 0.9% or Glucose 5%
      
  
        Methods of intravenous administration
  
                  Intermittent intravenous infusion (using an electronically controlled infusion device- due to risk of thrombophlebitis)
- Add to 250mL infusion fluid and administer over 60 minutes
 
- Administer through a large peripheral vein (ref 4)
 
- Central line - 5mg/mL (ref 1) if fluid overload is a greater risk to the patient than thrombophlebitis (must still be given over 60 minutes). e.g. 500mg in 100mL over 60 minutes
 
      
  
        Dose in adults
  
                  Usual dose
- Give 500mg every 12 hours
 
| Renal impairment (ref 2,3) | 
| eGFR (mL/minute/1.73m2) | 
Dose | 
Frequency | 
| less than 30 | 
250 to 500mg (for severe infection, use high end of dose range) | 
every 12 hours | 
Hepatic impairment
- Caution in hepatic impairment
 
- Avoid in severe hepatic impairment if renal impairment is also present
 
      
  
        Storage
  
                  
      
  
        References
  
                  Klacid SPC August 2024
1. "Critical Care Group: Minimum Infusion Volumes for fluid restricted critically ill patients". 2014. United Kingdom Clinical Pharmacy Association. www.ukcpa.org.uk
2. Renal drug database accessed online Jan 2025
3GUH antimicrobial guidelines
4. Injectable medicines guide, downloaded from Medusa 12/02/2025
Search term: Klacid
      
  
        Therapeutic classification
  
                  Macrolide antibiotic