Clarithromycin is a semisynthetic macrolide antibiotic with bactericidal activity against M. leprae greater than other macrolides although less bactericidal than minocycline. Its mechanism may be due to reduction of ATP in the bacteria. It is useful as an alternative to primary therapy due to either resistance or intolerance and has been used to treat lepromatous leprosy as monotherapy with success, although higher doses lead to some gastrointestinal distress. Clarithromycin 500 mg/day has been paired successfully with minocycline.
Pharmacotherapy. 2012;32(1):27-37. © 2012 Pharmacotherapy Publications