Telithromycin

What is Telithromycin

Telithromycin (HMR 3647) is a broad-spectrum antibiotic and the first in a family called ‘ketolides’.

Chemically, ketolides resemble macrolides, however, telithromycin exhibits greater antibacterial killing than macrolides. Telithromycin has been studied in multiple types of respiratory tract infections and its spectrum of activity is good against respiratory pathogens including erythromycin- and penicillin-resistant pneumococci.

Telithromycin also has activity against intracellular and atypical bacteria. Telithromycin once daily is as effective as clarithromycin, trovafloxacin, and high dose amoxicillin for some infections. Nearly 2500 patients have received telithromycin in clinical trials. 

Brand Name

Ketek

Indications

  1. Chlamydophila pneumoniae
  2. community-acquired pneumonia
  3. Coxiella burnetii
  4. Haemophilus influenzae (beta-lactamase negative)
  5. Haemophilus influenzae (beta-lactamase positive)
  6. Legionella pneumophila
  7. Moraxella catarrhalis
  8. Mycoplasma pneumoniae
  9. Staphylococcus aureus (MSSA)
  10. Streptococcus pneumoniae
  11. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  12. Streptococcus sp.

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. angioedema
  4. anorexia
  5. anosmia
  6. anxiety
  7. arthralgia
  8. blurred vision
  9. bradycardia
  10. candidiasis
  11. confusion
  12. constipation
  13. diarrhea
  14. diplopia
  15. dizziness
  16. drowsiness
  17. dysgeusia
  18. dysosmia
  19. dyspepsia
  20. dyspnea
  21. eczema vaccinatum
  22. elevated hepatic enzymes
  23. eosinophilia
  24. erythema multiforme
  25. fatigue
  26. flatulence
  27. flushing
  28. gastritis
  29. glossitis
  30. hallucinations
  31. hearing loss
  32. hepatic failure
  33. hepatic necrosis
  34. hepatitis
  35. hyperbilirubinemia
  36. hyperhidrosis
  37. hypotension
  38. insomnia
  39. jaundice
  40. muscle cramps
  41. myalgia
  42. myasthenia gravis
  43. nausea
  44. palpitations
  45. pancreatitis
  46. paresthesias
  47. pruritus
  48. pseudomembranous colitis
  49. QT prolongation
  50. rash
  51. stomatitis
  52. syncope
  53. thrombocytosis
  54. torsade de pointes
  55. tremor
  56. urticaria
  57. vaginitis
  58. ventricular tachycardia
  59. vertigo
  60. visual impairment
  61. vomiting
  62. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • alcoholism
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • children
  • colitis
  • coronary artery disease
  • diabetes mellitus
  • diarrhea
  • driving or operating machinery
  • females
  • geriatric
  • GI disease
  • heart failure
  • hepatic disease
  • hepatitis
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • infants
  • inflammatory bowel disease
  • jaundice
  • long QT syndrome
  • macrolide hypersensitivity
  • malnutrition
  • myasthenia gravis
  • myocardial infarction
  • neonates
  • pregnancy
  • pseudomembranous colitis
  • QT prolongation
  • renal failure
  • renal impairment
  • thyroid disease
  • viral infection

Interactions

  • Abarelix
  • Abemaciclib
  • Acalabrutinib
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
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  • Acetaminophen; Tramadol
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  • Ado-Trastuzumab emtansine
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  • Albuterol; Ipratropium
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  • Aliskiren; Valsartan
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  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
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