Telithromycin: a ketolide antibiotic for treatment of respiratory tract infections.
Telithromycin, a recently approved ketolide antibiotic derived from 14-membered macrolides, is active against erythromycin-resistant pneumococci. Telithromycin has enhanced activity in vitro because it binds not only to domain V of ribosomal RNA (like macrolides do) but also to domain II. However, it is not active against streptococci and staphylococci with constitutive macrolide, lincosamide, and streptogramin B resistance. Telithromycin, available in an oral formulation, is approved by the US Food and Drug Administration for use in adults for treatment of (1) community-acquired pneumonia due to Streptococcus pneumoniae (including multidrug-resistant isolates), Haemophilus influenzae, Moraxella catarrhalis, Chlamydia pneumoniae, or Mycoplasma pneumoniae; (2) acute exacerbation of chronic bronchitis due to S. pneumoniae, H. influenzae, or M. catarrhalis; or (3) acute bacterial sinusitis due to S. pneumoniae, H. influenzae, M. catarrhalis, or methicillin- and erythromycin-susceptible Streptococcus aureus. It is not approved for treatment of tonsillitis, pharyngitis, or severe pneumococcal pneumonia. Unique visual adverse effects occurred in 0.27%-2.1% of patients receiving telithromycin therapy. Its enhanced activity against some common respiratory pathogens makes it a valuable addition to the available macrolides.
Lonks
John R
JR
Division of Infectious Diseases, Brown Medical School and Miriam Hospital, Providence, RI 02912, USA. John_Lonks@brown.edu
Goldmann
Donald A
DA
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D004347:Drug Interactions; D024881:Drug Resistance, Bacterial; D006801:Humans; D048628:Ketolides / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D013329:Structure-Activity Relationship
D000900:Anti-Bacterial Agents; D048628:Ketolides; C106791:telithromycin