JAC Advance Access published online on March 13, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg153
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Spartanburg Pharmaceutical
Research, 126 Dillon Street, Spartanburg, SC 29307;
* Corresponding author. E-mail: cmf{at}bonetesting.com.
Received 26 June 2002
; revised 25 September 2002
; accepted 20 December 2002
The incidence of community-acquired respiratory tract
infections caused by Streptococcus pneumoniae exhibiting
antibacterial resistance has increased dramatically in recent years. Telithromycin
is the first of a new class of antibacterials, the ketolides, which
have been developed specifically to provide effective treatment
for these infections. Data were analysed from 3935 patients who
had participated in one Japanese Phase II study and 11 US/global
Phase III studies in three indications: community-acquired pneumonia,
acute exacerbations of chronic bronchitis or acute sinusitis. Patients
received either telithromycin 800 mg once daily or a comparator
antibacterial. S. pneumoniae isolates considered
to be causative for infection were tested for susceptibility to
penicillin G and erythromycin A. In per-protocol analyses, telithromycin
showed a high level of clinical efficacy against S.
pneumoniae, with clinical cure rates of 92.8% for
all isolates, 91.7% for those with reduced susceptibility
to penicillin G and 86.0% for those with reduced susceptibility
to erythromycin A. Bacterial eradication rates were consistent with
the clinical outcomes. High rates of clinical cure and bacterial
eradication were also observed for infections caused by isolates
demonstrating high-level resistance to erythro-mycin A [MICs
Keywords: telithromycin, ketolide, resistant S.
pneumoniae, clinical efficacy, bacteriological efficacy
Community-acquired respiratory tract infections
caused by resistant pneumococci: clinical and bacteriological efficacy
of the ketolide telithromycin
2 Nagasaki
University School of Medicine, Nagasaki, Japan
3 River Road Medical Group, Eugene,
OR, USA
4 Xavier Bichat School of Medicine,
Paris, France
5 ABM Research Institute,
Fresno, CA, USA
512 mg/L: 100% (13/13) clinical
cure, 100% (13/13) bacterial eradication]. These results
support the use of telithromycin as a first-line oral therapy for
the treatment of community-acquired respiratory tract infections
caused by S. pneumoniae with reduced susceptibility
to penicillin G and erythromycin A. 
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