"Clinical Pharmacology of Macrolides in Infants and Children"

Abstract

Macrolides used in paediatric patients are: erythromycin, clarithromycin, and azithromycin. The oral dose of erythromycin for children is 30 to 50 mg/kg daily divided into 4 portions. Clarithromycin usually is given twice-daily at a dose of 250 for adults with mild-to-moderate infections. In children, the recommended dose of azithromycin oral suspension for treating acute otitis media and pneumonia is 10 mg/kg on the first day (maximum 500 mg) and 5 mg (maximum 20 mg daily) on days 2 through 5. The dosing of erythromycin, clarithromycin, and azithromycin has been extensively described. The efficacy and safety of erythromycin, clarithromycin, and azithromycin have been reported. The pharmacokinetics of erythromycin estolate and ethylsuccinate have been studied in infants and the elimination half-life at the steady state is 6.56 and 2.34 hours, respectively. The pharmacokinetics of clarithromycin have been studied in infants and children, and the elimination half-life is about 4 hours. The pharmacokinetics of azithromycin have been studied in infants and children and the mean elimination half-life is 31.6 hours. The treatment of bacterial infections with erythromycin, clarithromycin, and azithromycin has been reported. Erythromycin, clarithromycin, and azithromycin poorly cross the human placenta and poorly migrate into the breast milk. The aim of this study is to review the dosing, pharmacokinetics, treatment, transfer across the human placenta, and the migration into the breast milk of erythromycin, clarithromycin, and azithromycin.