| Ketolides in the treatment of respiratory infections. | |
| | |
MedLine Citation:
|
PMID: 11866679 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The ketolides are a new class of macrolides specifically designed to combat respiratory tract pathogens that have acquired resistance to macrolides. The ketolides are semi-synthetic derivatives of the 14-membered macrolide erythromycin A. There are currently two ketolides in the late stages of clinical development in the US (telithromycin [HMR-364, Kelek; Aventis] and ABT-773 [Abbot Laboratories]), as well as newer compounds in earlier stages of testing. Ketolides have a mechanism of action very similar to that of erythromycin A. They potently inhibit protein synthesis by interacting close to the peptidyl transferase site of the bacterial 50S ribosomal subunit. Ketolides bind to ribosomes with higher affinity than macrolides. The ketolides exhibit good activity against Gram-positive and some Gram-negative aerobes and have are active against macrolide-resistant Streptococcus species, including most mef A and erm B strains of Streptococcus pneumoniae. Ketolides have pharmacokinetics which allow once-daily dosing and extensive tissue distribution with very high uptake into respiratory tissues and fluids relative to serum. Evidence suggests the ketolides are primarily metabolised by the cytochrome P450 (CYP) enzyme system in the liver and that elimination is a combination of biliary, hepatic and urinary excretion. Clinical trial data are only available for telithromycin and have focused on respiratory tract infections (RTIs) including community-acquired pneumonia (CAP), acute exacerbations of chronic bronchitis (AECB), sinusitis and streptococcal pharyngitis. Bacteriological and clinical cure rates have been similar to comparators. Ketolides have similar safety profiles to the newer macrolides. In summary, early clinical trials support the clinical efficacy of the ketolides in common RTIs, including activity against macrolide-resistant pathogens. |
| | |
Authors:
|
George G Zhanel; Daryl J Hoban |
Related Documents
:
|
2661319 - Specific binding of collagen type iv to streptococcus pyogenes. 14982799 - Ribosomal mutations in arcanobacterium pyogenes confer a unique spectrum of macrolide r... 19171799 - A novel gene, erm(41), confers inducible macrolide resistance to clinical isolates of m... 11709309 - High prevalence of inducible erythromycin resistance among streptococcus bovis isolates... 9436959 - Macrolides are ideal for empiric therapy of community-acquired pneumonia in the immunoc... 19869229 - Studies concerning the relationship between pneumococci and streptococci. 6319289 - Serotyping of cell culture-adapted subgroup 2 human rotavirus strains by neutralization. 20704509 - Comparison of detection methods for escherichia coli o157 in beef livers and carcasses. 18472369 - Antibiotic resistance in lactococcus species from bovine milk: presence of a mutated mu... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Expert opinion on pharmacotherapy Volume: 3 ISSN: 1465-6566 ISO Abbreviation: Expert Opin Pharmacother Publication Date: 2002 Mar |
Date Detail:
|
Created Date: 2002-02-27 Completed Date: 2002-09-20 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 100897346 Medline TA: Expert Opin Pharmacother Country: England |
Other Details:
|
Languages: eng Pagination: 277-97 Citation Subset: IM |
Affiliation:
|
Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Canada. ggzhanel@pcs.mb.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anti-Bacterial Agents
/
adverse effects,
economics,
pharmacokinetics,
pharmacology,
therapeutic use* Bacteria / drug effects Clinical Trials as Topic Drug Interactions Drug Resistance, Microbial Erythromycin / adverse effects, analogs & derivatives*, pharmacokinetics, pharmacology, therapeutic use* Humans Respiratory Tract Infections / drug therapy*, economics, microbiology Tissue Distribution |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Bacterial Agents; 114-07-8/Erythromycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Cost-effectiveness of antibiotic prophylaxis for bacterial arthritis.
Next Document: The use of retinoids in the prevention and treatment of skin cancer.