title: [Successful telithromycin therapy of Legionella pneumonia --report of three cases].
abstract: Legionella species have been widely recognized as among the important causative organisms of community-acquired pneumonia in Japan. A delay in the start of adequate treatment has a negative influence on the outcome of the disease. Telithromycin, the first oral ketolide antibacterial, was developed for the treatment of community-acquired pneumonia, including Legionella pneumonia. However, few reports have indicated the efficacy of telithromycin in community-acquired pneumonia caused by Legionella species. We report three cases of Legionella pneumonia, that were improved by early telithromycin therapy. The first patient (67-year-old man) had bronchiectasis as an underlying disease, and the second patient (73-year-old man) had diabetes mellitus and chronic renal failure. The third patient (62-year-old man) developed pneumonia after a spa tour. The diagnosis of Legionella pneumonia was made on the basis of the presence of a single IgG titer of 1/256 in case 1 and positive antigenuria in cases 2 and 3. The patients were classified into a mild group (case 1) and a moderate group (cases 2 and 3) based on the severity of the community-acquired pneumonia according to the 2005 Japanese Respiratory Society Guidelines. The results support the efficacy of telithromycin in mild to moderate Legionella pneumonia.
authors.affiliation: Department of Respiratory Medicine, Nishi-Kobe Medical Center.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Itoh
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tomioka
authors.forename: Masanori
authors.initials: M
authors.lastname: Isobe
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Kimihide
authors.initials: K
authors.lastname: Tada
authors.forename: Hironobu
authors.initials: H
authors.lastname: Iwasaki
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D048628:Ketolides / Q000627:therapeutic use*; D007877:Legionnaires' Disease / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D048628:Ketolides; C106791:telithromycin