Comparative activity of telithromycin against typical community-acquired respiratory pathogens

Abstract

This study demonstrates the rising prevalence of resistance among S. pneumoniae not only to penicillin but also to other antimicrobials. It also shows the value of telithromycin as an attractive option for the empirical treatment of community-acquired RTIs in an era of widespread antibacterial resistance.

In vitro Activity of Telithromycin against Respiratory Tract Pathogens in Comparison with Other Antimicrobial Agents

“…Penicillin remains an effective, inexpensive treatment for RTIs [2]. However, Hong Kong had a higher rate of penicillin-nonsusceptible S. pneumoniae [8] when compared to other parts of the world ranging from 5.9 to 8.7% [2, 9, 10].…”

“…Penicillin remains an effective, inexpensive treatment for RTIs [2]. However, Hong Kong had a higher rate of penicillin-nonsusceptible S. pneumoniae [8] when compared to other parts of the world ranging from 5.9 to 8.7% [2, 9, 10]. The percentages of penicillin-nonsusceptible S. pneumoniae in Hong Kong in 1996–2003 ranged from 49.3 to 60.6% [8, 9, 11, 12].…”

“…Macrolide resistance among S. pneumoniae was mainly due to adenine dimethyl coded by erm (B) gene and mef A efflux pump coded by mef (A) gene [12]. Telithromycin can overcome both macrolide resistance mechanisms either because of its high intrinsic activity and tight ribosomal binding, or because telithromycin is a poor substrate for efflux pumps [2]. Therefore, telithromycin is a new broad-spectrum antimicrobial agent for the treatment of S. pneumoniae infections.…”

“…Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae are common bacterial causes of respiratory tract infections (RTIs) such as otitis media, sinusitis, acute exacerbation of chronic bronchitis and pneumonia [1,2,3]. β-Lactam compounds or macrolides are commonly used to treat RTIs.…”

Resistencias bacterianas y farmacodinámica como bases de la prescripción de antibióticos en infecciones respiratorias

“…Con respecto a telitromicina, el AUC 24 de fármaco libre es de 5 mg/h/l, por lo que el punto de corte farmacodinámico sería de 0,2 mg/l, menor del establecido por el NCCLS (Յ 0,5 mg/l). En la figura 1 pueden observarse las tasas de AUC 24h /CIM 90 [80][81][82] : azitromicina, 2 mg/l; ciprofloxacino, 0,025; levofloxacino, 0,03; telitromicina, 4 mg/l. S. pneumoniae, pero no para H. influenzae, mientras que azitromicina quedaría por debajo frente a ambos patógenos.…”