1. Clarithromycin  250mg capsules orally 1 x2 x 10 days
2. dolocet  500mg tablets  1x 4 up to 2 x 4 until fever subside
3. Gurgle with salt and water solution (don’t swallow it ) 3 times daily
4. Soft food and warm drinks

Clarithromycin:

Dosage Forms & Strengths:

• 250mg tablet, 500mg tablet, 500 mg vial, 125mg/5ml suspension, 250 mg/5ml suspension.

Trade names  :

Klacid , Claritop, Klarimid , Claridar , Joclar , Klarilide, Eracid, Macromax, Klaribac , Clamycin, Claranta Claritt, Klrimed, Klamed, Clarix

Therapeutic indication and dose :

Acute Exacerbation of Chronic Bronchitis

• 250-500 mg PO q12hr for 7-14 days
• Extended release: 1000 mg PO once daily for 7 days

Acute Maxillary Sinusitis

• 500 mg PO q12hr for 14 days
• Extended release: 1000 mg PO once daily for 14 days

Mycobacterial Infection

• 500 mg PO q12hr for 7-14 days

Peptic Ulcer Disease

Indicated for H pylori eradication when treating patients with active or history of peptic ulcer disease

• 500 mg PO q8-12hr for 10-14 days

Administer as part of 2- or 3-drug combination regimen with bismuth subsalicylate, amoxicillin, H2 receptor antagonist, or proton pump inhibitor

Pharyngitis, Tonsillitis

• 250 mg PO q12hr for 10 days

Community-Acquired Pneumonia

• 250 mg PO q12hr for 7-14 days
• Extended release: 1000 mg PO once daily for 7 days

Skin/Skin Structure Infection

• 250 mg PO q12hr for 7-14 days

Pertussis (Off-label)

Used off-label for treatment of pertussis or for postexposure prophylaxis

• 500 mg PO twice daily for 7 days

Endocarditis (Off-label)

Used off-label for bacterial endocarditis prophylaxis

• 500 mg PO 30-60 minutes before procedure

Contraindications:

• Hypersensitivity to the active substance clarithromycin, to other macrolides
• Electrolyte disturbances (hypokalaemia or hypomagnesaemia, due to the risk of prolongation of the QT interval). 
• Severe hepatic failure in combination with renal impairment. 
• Clarithromycin should not be used concomitantly with statins (lovastatin or simvastatin), due to the increased risk of myopathy, including rhabdomyolysis

Pregnancy:

• The safety of clarithromycin for use during pregnancy has not been established. . 
• Some observational studies evaluating exposure to clarithromycin during the first and second trimester have reported an increased risk of miscarriage compared to no antibiotic use or other antibiotic use during the same period. 
• Therefore, use during pregnancy is not advised without carefully weighing the benefits against risks.

Breastfeeding :

• The safety of clarithromycin for use during breast feeding of infants has not been established. 

Clarithromycin is excreted into human breast milk in small amounts

Common side effects:

• Abdominal pain
• Diarrhea
• Nausea
• Vomiting and taste perversion

Paractamol

• Analgesic and antipyretics
• Not anti-inflammatory effect
• Suitable for Temperature between (37.5C – 38.5C)
• Safe under 6 months

Trade names  : ( Revanin ,Adol,Panda,Dolocet ,Feverol, panadol )

Concentrations: 500 mg tablet, ,1g tablet ,125 mg/5 ml syrup, 250 mg/5 ml syrup, 125 mg suppositories, 250 mg suppositories, 1g/100ml solution for infusion

Dose : 

Tablet, capsule : 

• 500mg tabs 1-2 tabs /cap every 6 hours

Syrup, suspension :

• < 5year  : 125mg/5ml susp (w/2) Every 4 – 6 hours
• 5-12 year : 250mg/5ml susp (w/4) Every 4 – 6 hours 

Suppositories :

• <1Y : 125 mg supp Every 8 hours  (1 supp x 3 )
• >1Y : 250mg supp Every 8 hours ( 1supp x 3 )

Iv solution 1g/100ml :

• <10kg : 0 .75ml/kg 
• >10kg , <50kg :  1.5ml/kg
• >50kg : 100ml Slowly over 15 minute

Maximum dose : 4g daily 

Pregnancy and lactation : Paracetamol is the first choice of painkiller in pregnancy and breastfeeding