CLARITHROMYCIN - PHARMACOKINETICS, CLINIC AL EFFECTIVENESS TRANSMISSION INTO BREAST-MILK OF A NEW MACROLIDE ANTIBIOTIC IN PATIENTS WITH PUERPERAL INFECTIONS

The aims of this study were, to determine the pharmacokinetic paramete rs of clarithromycin and to study the passage of the drug into breast milk. Twelve patients (age 24 to 38; weight 44 to 83 kg), suffering fr om puerperal infections, were treated orally with 250 mg clarithromyci n b.i.d. for 6 days. Samples of blood and breast milk were taken at ti med intervals. The specimens were assayed for clarithromycin and its a ctive metabolite 14-hydroxy-clarithromycin by HPLC and electrochemical detection. Serum concentrations of clarithromycin in the investigated patients were higher than those reported in healthy volunteers. The m ean peak concentrations of clarithromycin and 14-hydroxy-clarithromyci n in breast milk were about 25 %, and 75 % respectively of the corresp onding serum concentrations. All patients recovered within 2 to 4 days and no drug-associated side effects (eg. gastrointestinal) were noted . Clarithromycin appears to be an appropriate antibiotic for the treat ment of puerperal infections and (because of its considerable concentr ations in breast milk) for puerperal mastitis as well.