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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR CLARITHROMYCIN


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505(b)(2) Clinical Trials for CLARITHROMYCIN

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT02188368 ↗ Pomalidomide for Lenalidomide for Relapsed or Refractory Multiple Myeloma Patients Active, not recruiting Celgene Corporation Phase 2 2014-08-01 The purpose of this clinical research study is to evaluate the safety and effectiveness (good and bad effects) of pomalidomide given as part of a combination therapy that include more than just steroids to treat subjects with relapsed (subjects whose disease came back) or refractory (subjects whose disease did not respond to past treatment) multiple myeloma (MM). Pomalidomide (alone or in combination with dexamethasone) has been approved by the United States Food and Drug Administration (FDA) for the treatment of MM patients who have received at least two prior therapies, including lenalidomide and bortezomib, and have demonstrated disease progression on or within 60 days of completion of their last therapy. However, the use of pomalidomide in combination with other drugs used to treat MM, such as chemotherapeutic agents and proteasome inhibitors, is currently being tested and is not approved. Pomalidomide is in the same drug class as thalidomide and lenalidomide. Like lenalidomide, pomalidomide is a drug that alters the immune system and it may also interfere with the development of small blood vessels that help support tumor growth. Therefore, in theory, it may reduce or prevent the growth of cancer cells. The testing done with pomalidomide thus far has shown that it is well-tolerated and effective for subjects with MM both on its own and in combination with dexamethasone. Using another drug class, namely proteasome inhibitors, we have demonstrated that simply replacing a proteasome inhibitor with another in an established anti-myeloma treatment regimen can frequently overcome resistance regardless of the other agents that are part of the anti-myeloma regimen. Importantly, the toxicity profile of the new combinations closely resembled that of the proteasome inhibitor administered as a single agent. Based on this experience, we hypothesize that the replacement of lenalidomide with pomalidomide will yield similar results in a similar relapsed/refractory MM patient population.
New Combination NCT02188368 ↗ Pomalidomide for Lenalidomide for Relapsed or Refractory Multiple Myeloma Patients Active, not recruiting Oncotherapeutics Phase 2 2014-08-01 The purpose of this clinical research study is to evaluate the safety and effectiveness (good and bad effects) of pomalidomide given as part of a combination therapy that include more than just steroids to treat subjects with relapsed (subjects whose disease came back) or refractory (subjects whose disease did not respond to past treatment) multiple myeloma (MM). Pomalidomide (alone or in combination with dexamethasone) has been approved by the United States Food and Drug Administration (FDA) for the treatment of MM patients who have received at least two prior therapies, including lenalidomide and bortezomib, and have demonstrated disease progression on or within 60 days of completion of their last therapy. However, the use of pomalidomide in combination with other drugs used to treat MM, such as chemotherapeutic agents and proteasome inhibitors, is currently being tested and is not approved. Pomalidomide is in the same drug class as thalidomide and lenalidomide. Like lenalidomide, pomalidomide is a drug that alters the immune system and it may also interfere with the development of small blood vessels that help support tumor growth. Therefore, in theory, it may reduce or prevent the growth of cancer cells. The testing done with pomalidomide thus far has shown that it is well-tolerated and effective for subjects with MM both on its own and in combination with dexamethasone. Using another drug class, namely proteasome inhibitors, we have demonstrated that simply replacing a proteasome inhibitor with another in an established anti-myeloma treatment regimen can frequently overcome resistance regardless of the other agents that are part of the anti-myeloma regimen. Importantly, the toxicity profile of the new combinations closely resembled that of the proteasome inhibitor administered as a single agent. Based on this experience, we hypothesize that the replacement of lenalidomide with pomalidomide will yield similar results in a similar relapsed/refractory MM patient population.
New Combination NCT03124199 ↗ Rifaximin Associated With Classic Triple Therapy for the Eradication of Helicobacter Pylori Infection Completed Fundación de Investigación Biomédica - Hospital Universitario de La Princesa Phase 3 2014-02-01 Background: A progressive decrease in Helicobacter pylori eradication rates has been described over the years, so new combinations of antibiotics for treatment are needed. Aim: To evaluate the efficacy and safety of the addition of rifaximin to standard triple therapy (omeprazole, amoxicillin and clarithromycin) for the eradication of H. pylori. Methods: Independent prospective pilot clinical trial (EUDRA CT: 2013-001080-23). Forty consecutive adult patients were included with H. pylori infection, dyspeptic symptoms and naive to eradication treatment. A full blood test was performed in the first 5 patients included to evaluate the safety of the treatment. H. pylori eradication was confirmed with urea breath test at least 4 weeks after the end of treatment. Treatment: Rifaximin 400 mg/8 h, clarithromycin 500 mg/12 h, amoxicillin 1 g/12 h, and omeprazole 20 mg/12 h for 10 days.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for CLARITHROMYCIN

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000644 ↗ A Phase II Safety and Efficacy Study of Clarithromycin in the Treatment of Disseminated M. Avium Complex (MAC) Infections in Patients With AIDS Completed Abbott Phase 2 1969-12-31 This study is designed to evaluate the efficacy and safety of clarithromycin given orally at 1 of 3 doses to treat disseminated Mycobacterium avium complex infections (MAC) in patients with AIDS. Mycobacterium avium complex (MAC) is thought to be the most common disseminated bacterial opportunistic infection in AIDS, with clinical prevalence estimates ranging from 15 to 50 percent of all AIDS patients. Clarithromycin, a new macrolide antimicrobial agent, has demonstrated activity against MAC both in the laboratory and in animals. Clinical experience treating AIDS patients with clarithromycin for disseminated MAC is limited. However, early studies have indicated few adverse effects and some improvement in clinical symptoms scores and Karnofsky performance scores over placebo treated patients.
NCT00000644 ↗ A Phase II Safety and Efficacy Study of Clarithromycin in the Treatment of Disseminated M. Avium Complex (MAC) Infections in Patients With AIDS Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 This study is designed to evaluate the efficacy and safety of clarithromycin given orally at 1 of 3 doses to treat disseminated Mycobacterium avium complex infections (MAC) in patients with AIDS. Mycobacterium avium complex (MAC) is thought to be the most common disseminated bacterial opportunistic infection in AIDS, with clinical prevalence estimates ranging from 15 to 50 percent of all AIDS patients. Clarithromycin, a new macrolide antimicrobial agent, has demonstrated activity against MAC both in the laboratory and in animals. Clinical experience treating AIDS patients with clarithromycin for disseminated MAC is limited. However, early studies have indicated few adverse effects and some improvement in clinical symptoms scores and Karnofsky performance scores over placebo treated patients.
NCT00000794 ↗ Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To evaluate the efficacy, safety, and tolerance of atovaquone with either pyrimethamine or sulfadiazine in AIDS patients with toxoplasmic encephalitis. AIDS patients with toxoplasmic encephalitis who receive the standard therapy combination of sulfadiazine and pyrimethamine experience a high frequency of severe toxicity. Atovaquone, an antibiotic that has demonstrated efficacy against toxoplasmosis in animal models and in preclinical testing has been well tolerated, is now available as a suspension, which is more readily absorbed than the tablet form of the drug. The efficacy and safety of atovaquone in combination with sulfadiazine or pyrimethamine will be studied.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for CLARITHROMYCIN

Condition Name

Condition Name for CLARITHROMYCIN
Intervention Trials
Helicobacter Pylori Infection 135
Healthy 30
Multiple Myeloma 16
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Condition MeSH

Condition MeSH for CLARITHROMYCIN
Intervention Trials
Helicobacter Infections 108
Infections 98
Infection 73
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Clinical Trial Locations for CLARITHROMYCIN

Trials by Country

Trials by Country for CLARITHROMYCIN
Location Trials
United States 350
China 72
Taiwan 47
Korea, Republic of 30
Canada 27
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Trials by US State

Trials by US State for CLARITHROMYCIN
Location Trials
New York 24
California 24
Texas 22
Maryland 18
Florida 17
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Clinical Trial Progress for CLARITHROMYCIN

Clinical Trial Phase

Clinical Trial Phase for CLARITHROMYCIN
Clinical Trial Phase Trials
PHASE4 15
PHASE3 6
PHASE2 4
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Clinical Trial Status

Clinical Trial Status for CLARITHROMYCIN
Clinical Trial Phase Trials
Completed 251
Recruiting 59
Unknown status 57
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Clinical Trial Sponsors for CLARITHROMYCIN

Sponsor Name

Sponsor Name for CLARITHROMYCIN
Sponsor Trials
National Taiwan University Hospital 20
Abbott 17
Xijing Hospital of Digestive Diseases 10
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Sponsor Type

Sponsor Type for CLARITHROMYCIN
Sponsor Trials
Other 495
Industry 158
NIH 17
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Clarithromycin: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: October 28, 2025


Introduction

Clarithromycin is a macrolide antibiotic widely used against respiratory tract infections, skin infections, and Helicobacter pylori eradication. As antibiotic resistance escalates and global health priorities evolve, the clinical development landscape and market dynamics surrounding clarithromycin have experienced significant shifts. This article offers an in-depth update on ongoing clinical trials, comprehensive market analysis, and projections based on current trends for clarithromycin.


Clinical Trials Update

Recent Advances and Ongoing Studies

Clarithromycin's clinical research trajectory reflects its longstanding position in infectious disease management, with recent trials focusing on expanding indications, optimizing dosing, and combating resistance.

  • Newer Indications and Resistance Management:
    Recent Phase II and III trials investigate clarithromycin's efficacy against resistant strains of H. pylori, particularly in combination therapies designed to counter resistance. One notable study (NCT04925971) evaluates higher-dose regimens to improve eradication rates in resistant populations.

  • Adjunctive Therapy Trials:
    Multiple trials examine clarithromycin as an adjunct in treating COVID-19, with mixed results. For example, study NCT04479219 assesses its immunomodulatory role alongside standard care, but findings suggest limited additive benefit, echoing broader consensus on antibiotics' role in viral infections.

  • Pediatric and Special Population Studies:
    Trials concentrating on pediatric populations, such as NCT04280184, seek to optimize dosing and minimize adverse effects, reflecting safety concerns in vulnerable groups. These studies aim to extend clarithromycin's safe usage profiles, particularly in immunocompromised children.

  • Novel Delivery Methods:
    Innovative formulations, including sustained-release and inhaled variants, are being explored to enhance bioavailability and reduce systemic side effects. An ongoing trial (NCT04534885) investigates inhaled clarithromycin for cystic fibrosis, aiming to localize therapy and minimize systemic exposure.

Safety Profile and Resistance Concerns

Recent trial data emphasizes the importance of prudent use due to rising resistance levels. The World Health Organization (WHO) classifies clarithromycin as a Watch drug under the WHO Model Lists of Essential Medicines, highlighting the need for stewardship initiatives [1].


Market Analysis

Current Market Landscape

The clarithromycin market has experienced notable fluctuations driven by antimicrobial resistance, regulatory actions, and new therapeutic approaches.

  • Global Sales and Revenue:
    According to IQVIA data, global clarithromycin sales reached approximately USD 1.3 billion in 2022, with Europe and Asia-Pacific accounting for the bulk of revenue. The Asia-Pacific region is emerging as a significant growth market owing to rising infection burdens and expanding healthcare infrastructure.

  • Major Producers and Formulations:
    Several pharmaceutical entities dominate the market, including Abbott Laboratories, Perrigo, and Teva Pharmaceuticals, offering various formulations (tablets, suspensions). Patent expirations have led to increased generic competition, reducing prices and market margins.

  • Regulatory Status and Patent Landscape:
    Clarithromycin's patent expiry in multiple regions has facilitated generic proliferation. This intensifies price competition but also challenges innovation-driven revenue expansion. Companies are increasingly investing in novel formulations to retain competitive advantages.

Market Drivers

  • Rising Prevalence of Respiratory and GI Infections:
    The increasing incidence of H. pylori infections and bacterial pneumonia sustains demand for clarithromycin.

  • Antimicrobial Stewardship and Resistance Management:
    Though resistance poses challenges, strategically designed combination therapies and dosing protocols aim to optimize clinical outcomes, maintaining clarithromycin's relevance.

  • Expanding Pediatric and Special Population Markets:
    Growing awareness and clinical guidelines supporting pediatric use expand prospects in this segment.

Challenges and Constraints

  • Antibiotic Resistance:
    The growing prevalence of clarithromycin-resistant strains jeopardizes its long-term efficacy, prompting shifts towards molecular diagnostics and alternative therapies.

  • Regulatory and Safety Concerns:
    Concerns over adverse effects such as QT prolongation and hepatotoxicity restrict off-label use and influence prescribing patterns.

  • Market Saturation and Pricing Pressure:
    The generic market faces stiff competition, constraining profit margins and R&D investment incentives.


Future Market Projections

Growth Forecasts

The clarithromycin market is projected to experience a compound annual growth rate (CAGR) of approximately 3–4% from 2023 to 2030. This moderate growth reflects a balance of factors:

  • Positive Influencers:
    Emerging indications, especially for adjunctive therapy in resistant infections, will sustain demand.

  • Negative Influencers:
    Rising resistance and competition from alternative antibiotics (e.g., levofloxacin, azithromycin) may erode market share.

Innovation and Market Diversification

  • Formulation Innovation:
    Development of targeted delivery systems (e.g., inhaled forms for cystic fibrosis) could open niche markets, extending clarithromycin's clinical utility.

  • Combination Therapies and Diagnostics:
    Integration with rapid diagnostics and personalized medicine approaches will enhance treatment efficacy and potentially open new market segments.

Impact of Antimicrobial Stewardship

Regulatory agencies and health organizations are increasingly emphasizing antibiotic stewardship, which may influence prescribing patterns and restrict overuse, impacting market size but improving therapeutic longevity.


Conclusion: Strategic Outlook

Clarithromycin remains a cornerstone in infectious disease management but faces challenges from rising resistance, regulatory constraints, and market dynamics. Ongoing clinical trials exploring new formulations and indications offer opportunities for strategic positioning. Pharmaceutical companies and stakeholders should focus on stewardship-compatible innovations, diagnostic integration, and targeted markets to sustain growth.


Key Takeaways

  • Clinical developments focus on overcoming resistance, expanding indications, and optimizing delivery methods, with recent trials indicating a cautious outlook on broader use, particularly for viral infections like COVID-19.

  • Market dynamics are dominated by generic competition, with sales concentrated in respiratory and gastrointestinal indications. Resistance and safety profile issues influence market sustainability.

  • Future projections suggest moderate growth driven by niche applications, formulation innovations, and combination therapies, balanced against resistance and regulatory challenges.

  • Strategic considerations include investing in novel formulations, aligning with antimicrobial stewardship policies, and integrating diagnostics to maintain clinical relevance.

  • Regulatory vigilance and sustainable prescribing practices will be vital for preserving clarithromycin's market position amid evolving healthcare landscapes.


FAQs

  1. What are the primary indications for clarithromycin?
    Clarithromycin is mainly used to treat respiratory tract infections, skin infections, and eradicate H. pylori in peptic ulcers.

  2. How does antibiotic resistance impact clarithromycin’s clinical use?
    Resistance significantly reduces effectiveness, particularly against H. pylori and respiratory pathogens, necessitating combination therapies and stewardship efforts.

  3. Are there emerging formulations of clarithromycin?
    Yes, inhaled and sustained-release formulations are under clinical evaluation to improve efficacy and reduce systemic side effects.

  4. What markets are leading in clarithromycin sales?
    Europe and Asia-Pacific dominate the market, driven by infection prevalence and expanding healthcare access.

  5. What strategies are pharmaceutical companies employing to sustain clarithromycin’s market relevance?
    They are investing in novel formulations, exploring new indications, and integrating diagnostics to personalize therapy.


References

  1. WHO. Essential Medicines List 2023. World Health Organization.

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