As a replacement for clarithromycin at 25 mg/ml, clarithromycin at 50 mg/ml or azithromycin at 40 mg/ml in oral form may be prescribed in compliance with the instructions. recommendations for proper use of clarithromycin.
To limit as much as possible the impact of current supply tensions and to guarantee that patients’ needs are covered, the ANSM invites the following recommendations to be followed for the youngest children:
Recommendations for doctors
If the child weighs less than 4 kg:
- You can prescribe clarithromycin at 25 mg/ml in oral suspension.
If the child weighs 4 kg or more:
- Prescribe clarithromycin at 50 mg/ml in oral suspension, the dosing syringe being graduated in kilograms for weights from 4 kg.
Regardless of the child’s weight:
- anticipate the possible unavailability of oral clarithromycin by co-prescribing, as an alternative, an oral suspension of azithromycin at 40 mg/ml and mentioning its administration schedule on the prescription;
- inform parents in the event of co-prescription, in compliance with recommendations for proper use of clarithromycin.
In all cases, be sure to specify the presentations and dosages of the medications prescribed, as well as the weight of the child on the prescription to facilitate dispensing and administration to the child.
Consult the table of presentations of oral suspensions according to the weight of children
Recommendations for pharmacists
- The dispensation of clarithromycin at 25 mg/ml in oral suspension must be temporarily reserved for children weighing less than 4 kg;
- Clarithromycin at 50 mg/ml in oral suspension can be used in children weighing 4 kg or more, the dosing syringe being graduated in kilograms for weights starting from 4 kg.
Alternatively, you may be required to dispense azithromycin at 40 mg/ml in oral suspension to replace oral clarithromycin, provided that the doctor has indicated this on the prescription or after contacting the doctor if the prescription does not mention it.
In all cases, check that the parents have understood how to administer the antibiotic with the medication dosing syringe to avoid any dosage errors.
Information for parents of young children
- Your child weighs less than 4 kg : the doctor may be required to prescribe clarithromycin at 25 mg/ml in drinkable form;
- Your child weighs 4 kg or more : the doctor may be required to prescribe clarithromycin at 50 mg/ml in drinkable form.
Due to current stock shortages of clarithromycin, your doctor may have listed another antibiotic, azithromycin, on the prescription in case clarithromycin is not immediately available at your pharmacy.
In all cases, strictly follow the dosage specified on the prescription and use the pipette graduated in kilograms provided in the medicine box.
The doctor’s prescription mentions the dosage of these antibiotics according to the child’s weight and can be written in “dose/kg” per dose. The dose to be taken by your child can be read directly using the graduations on the pipette, the weight indicated corresponding to the dose for one dose.
Ask the pharmacist for advice if you have any questions regarding the use of the medicine given to you. Do not hesitate to question him, particularly in the event of difficulty reading the dose to be given to the child with the pipette, in particular if you cannot find the number of kilograms corresponding to your child’s weight on the graduations of the pipette.
Strict monitoring of the prescription is essential to ensure the effectiveness of the treatment and the safety of your child.
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Source: ANSM news from 11/28/2024
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