Клиническая фармакология и практическое использование кларитромицина


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Аннотация

Кларитромицин – 14-членный полусинтетический макролидный антибиотик. Используется в клинической практике с 1991 г. В статье представлены современные данные по фармакокинетике, фармакодинамике, профилю безопасности препарата, распространенности и клиническому значению вторичной резистентности ключевых возбудителей, показания к применению. Обсуждаются перспективы клинического использования неантимикробных эффектов кларитромицина. Кларитромицин – 14-членный полусинтетический макролидный антибиотик, производное эритромицина А – характеризуется наличием метоксигруппы в позиции 6- макроциклического лактонного кольца, что придает ему повышенную кислотостабильность и улучшенные по сравнению с эритромицином фармакодинамические и фармакокинетические свойства.Кларитромицин занимает одно из лидирующих мест на фармацевтическом рынке РФ с широким кругом показаний к применению. Традиционно кларитромицин рассматривался как "амбулаторный" АМП, что обусловлено особенностями спектра активности (преимущественно грамположительные бактерии и атипичные микроорганизмы), благоприятным профилем безопасности. Внедрение ЛФ с замедленным высвобождением позволит улучшить переносимость и повысить комплаентность к проводимой терапии.Резистентность S. pneumoniae и S. pyogenes к кларитромицину в мире для РФ пока не представляет существенной проблемы и не ограничивает использование препарата для эмпирической терапии респираторных инфекций.Неантимикробные эффекты кларитромицина открывают новые перспективы для его клинического применения, однако необходимы дальнейшие исследования, которые позволят не только детально изучить механизм противовоспалительного и иммуномодулирующего действия кларитромицина, но и оценить продолжительность указанных эффектов.

Об авторах

С. А Рачина

Смоленская государственная медицинская академия

Кафедра клинической фармакологии

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