JAC Advance Access published online on July 29, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg359
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of Internal
Medicine IV, Division of Pulmonology, University of
Vienna, General Hospital of Vienna,
Währinger Gürtel 18-20, A-1090 Vienna,
Austria
* Corresponding author. E-mail: apostolos.georgopoulos{at}akh-wien.ac.at.
Received 6 April 2003
; revised 30 May 2003
; accepted 4 June 2003
Objectives: Respiratory tract infections
(RTIs) remain a significant cause of morbidity and mortality. Major bacterial
pathogens in RTIs, such as Streptococcus pneumoniae,
have exhibited increasing resistance to a variety of antibiotics
during the past decades. Telithromycin, the first ketolide, was
designed especially to overcome this resistance. The present study
was conducted to assess the comparative activity of telithromycin
against typical RTI pathogens in Austria. Methods: A total of 1015 bacterial isolates
was tested, including S. pneumoniae, Streptococcus
pyogenes, Staphylococcus aureus and Haemophilus
influenzae. MICs of the following antimicrobials: penicillin
G, ampicillin (for H. influenzae), azithromycin,
clarithromycin, erythromycin A and telithromycin were determined
using the NCCLS broth microdilution method. Results: Telithromycin showed excellent activity
against S. pneumoniae, with 99.8% of all
isolates being susceptible. Penicillin remained active with an MIC50 and
MIC90 of 0.007 mg/L. Nevertheless, a notable increase
in penicillin intermediate-resistant and resistant isolates, from
4.9% in 1996 to the present rate of 10%, was observed.
There was also a distinct rise in the resistance levels of S.
pneumoniae against the macrolides. All tested isolates of S. pyogenes were susceptible to penicillin and
telithromycin, and only low levels of resistance against telithromycin
were found in S. aureus (2.2%, MIC90 of
0.5 mg/L). No telithromycin-resistant isolate of H.
influenzae could be detected. Conclusions: 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.
Keywords: ketolides, susceptibilities, streptococci
Comparative activity of telithromycin against typical
community-acquired respiratory pathogens
2 Department of Internal Medicine I,
Division of Infectious Diseases and Chemotherapy, University of
Vienna, General Hospital of Vienna,
Währinger Gürtel 18-20, A-1090 Vienna,
Austria
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