Journal of Antimicrobial Chemotherapy (2001) 48, 0III-iii
© 2001 The British Society for Antimicrobial Chemotherapy
Supplement |
Preface
London, UK, August 2001 Birmingham, UK, August 2001
Abstract
Macrolide antibiotics have been available for some 40 years. During that time they have proved to be invaluable for treating specific infections and have displayed, in particular, a low level of serious adverse effects. Unfortunately, in recent years there has been an accelerating rise in acquired resistance in some bacterial pathogens which has now reached a level that threatens the usefulness of existing macrolides. Newer macrolides have been introduced that have greater inherent activity and enhanced pharmacokinetic properties, but these have shown crossresistance with the older macrolides and with one another. Modification of the ring structure of erythromycin has produced a new class of antibiotics, the ketolides, which is a novel addition to the macrolidelincosamide-streptogramin group of antibiotics. These new agents show activity against strains of pathogens with acquired resistance to erythromycin, due either to erm-mediated modification of the ribosomal target site or to mef-mediated macrolide efflux. This supplement contains four reviews that give a comprehensive overview of the structure–activity relationships of members of the ketolides, and explore in detail the in vitro activity of the first member of this class to undergo clinical development, telithromycin. If the promise from its initial clinical trials is borne out, the ketolides may prove a valuable new resource, particularly for the treatment of respiratory tract infections, which remain a significant cause of morbidity and mortality around the world.