SEARCH · PubMed Health

Results for “RESPIRATORY TRACT”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources

PubMed1991

Erythromycin and phenoxymethylpenicillin (penicillin V) in the treatment of respiratory tract infections as related to microbiological findings and serum C-reactive protein.

Respiratory tract pathogens (beta-haemolytic streptococci groups A, C and G, Haemophilus influenzae, Branhamella catarrhalis or pneumococci), were isolated from nasopharyngeal and/or throat swabs in 73/138 (53%) patients greater than 10 years of age with a clinical diagnosis of acute sinusitis, acute tonsillitis, purulent nasopharyngitis or acute bronchitis. Serological evidence of a viral infection (influenza A and B, parainfluenza 1, 2 and 3, respiratory syncytial virus, adenovirus) or Mycoplasma pneumoniae infection was found in 10% of the patients. The serum content of C-reactive protein (S-CRP) was increased (greater than 12 mg/l) in 26/33 (79%) patients with streptococci and in 22/59 (37%) patients without respiratory tract bacteria. In patients with a serological evidence of a virus tonsillitis, the S-CRP was also high (32-64 mg/l). At follow-up 10-12 days after the first visit, the clinical effect of erythromycin and penicillin V was judged to be similar (90% clinical effect). Relapse or re-infection with group A streptococci were seen in 7 patients (4 on erythromycin, 3 on penicillin). In another 6 patients (3 on erythromycin, 3 on penicillin), antibiotic treatment was switched owing to persisting symptoms, probably due to H. Influenzae infection in 3 cases. The patients' own estimates of their symptoms suggested treatment with erythromycin to have a more rapid effect than treatment with penicillin.

Acute Disease↗

PubMed1999

Day care attendance in the first year of life and illnesses of the upper and lower respiratory tract in children with a familial history of atopy.

OBJECTIVE: To examine the relationship between day care attendance and illnesses of the upper and lower respiratory tract in the first year of life. STUDY DESIGN: Prospective birth cohort study. METHODS: Children (N = 498) who had at least 1 parent with a history of allergy or asthma were enrolled at birth and followed prospectively for the first year of life. A home visit at 2 to 3 months of age and bimonthly telephone questionnaires were used to obtain information on day care arrangements, home characteristics, respiratory symptoms, and physician-diagnosed illnesses of the upper and lower respiratory tract. RESULTS: Day care attendance in the first year of life was associated with two or more doctor-diagnosed ear infections (OR: 2.4; 95% CI: 1.7-3.6), three or more parental reports of runny or stuffed nose (OR: 3.2; 95% CI: 1.9-5.5), a doctor's diagnosis of sinusitis (OR: 2.2; 95% CI: 1.1-4.2), and doctor-diagnosed lower respiratory illnesses (croup, bronchitis, bronchiolitis, and pneumonia; OR: 1.6; 95% CI: 1.0-2.4). For children attending day care, exposure to pets in day care, the presence of a rug or carpet in the area where the child slept in day care, and a nonresidential setting for day care all were independent predictors of two or more doctor-diagnosed ear infections. CONCLUSIONS: The results suggest that day care increases the risk of illnesses of the upper and lower respiratory tract in the first year of life for children with a familial history of atopy. Specific environmental exposures within day care, such as the presence of pets or having a rug or carpet in the area where children sleep, may increase the risk of recurrent ear infections in the first year of life among children with familial history of atopy who attend day care.

Asthma↗

PubMedDate not supplied

Efficacy and safety of Sultamicillin (Ampicillin/Sulbactan) and Amoxicillin/Clavulanic acid in the treatment of upper respiratory tract infections in adults--an open-label, multicentric, randomized trial.

UNLABELLED: Upper respiratory tract infections are the most common causes of medical visits in children and adults, demanding massive use of antibiotics. Bacterial resistance caused by beta-lactamase is one of the most serious problems in this matter. Sultamicillin, a double pro-drug of Ampicillin/Sulbactan, is a potent beta-lactamase inhibitor which can face this challenge. AIM: Evaluate efficacy, safety and tolerability of Ampicillin/Sulbactan compared to Amoxicillin/Clavulanate in upper respiratory tract infections in adults. METHODS: 102 patients were enrolled and randomized to receive Ampicillin/Sulbactan or Amoxicillin/Clavulanate during 10 days. They were evaluated 10 and 30 days after treatment to learn about the therapeutic response. RESULTS: There were no differences between the two groups respecting cure at the end of treatment (visit 2) or at the end of the study (visit 3). Cure ratio was 61.7% and 93.2% (visits 2 and 3) in the Amoxicillin/Clavulanate group compared to 64.4% and 97.4%, respectively, in Ampicillin/Sulbactan group. The adverse events ratio for the two groups was the same (p=0.940). The number of patients with diarrhea was greater in the group of patients receiving Amoxicillin/Clavulanate (70.6%) than in the group receiving Ampicillin/Sulbactan (29.4%) (p=0.0164). CONCLUSIONS: Ampicillin/Sulbactan is as safe and efficient as Amoxicillin/Clavulanate in the empiric treatment of upper respiratory infections in adults. The low occurrence of diarrhea in the group receiving Ampicillin/Sulbactan needs confirmation in other studies.

Adult↗

PubMed2003

Oxochromium(V) species formed with 2,3-dehydro-2-deoxy-N-acetylneuraminic or N-acetylneuraminic (sialic) acids: an in vitro model system of oxochromium(V) species potentially stabilized in the respiratory tract upon inhalation of carcinogenic chromium(VI) compounds.

The human respiratory tract is rich in sialoglycoconjugates. These polyfunctional, oxygen-rich molecules stabilize potentially genotoxic oxoCr(V) species, which has relevance to the metabolic fate of carcinogenic Cr(VI) compounds when inhaled as dusts, mists, and fumes during occupational exposure. A series of oxoCr(V) species formed from solutions of Cr(VI) and the reductant, glutathione (GSH), in the presence of an excess of small molecule ligands that model sialoglycoconjugates, either 2,3-dehydro-2-deoxy-N-acetylneuraminic acid (I) or N-acetylneuraminic acid (II), have been characterized as a function of pH value, using electron paramagnetic resonance (EPR) spectroscopy (Cr(V) = d(1)). Where [I] or [II] is in large excess of [Cr(V)-GSH], oxoCr(V)-I or -II species form (g(iso) = 1.97-1.98) via ligand-exchange reactions in which oxygen donor atoms from the carboxylic acid (I), tert-2-hydroxycarboxylato(2-) (II), and/or diolato(2-) groups (I, II) feature in the oxoCr(V) coordination sphere. At pH approximately 7.1 (where [Cr(V)-GSH]:[II] << 1), the oxoCr(V)-II complexes remain EPR active for 24 h (with t(1/2) approximately 380 min). The parent EPR spectrum from oxoCr(V)-I or -II solutions represents the sum of spectra from individual linkage isomers; using EPR spectral simulation procedures, coupled with empirical EPR spectroscopic data for previously characterized oxoCr(V)-hydroxycarboxylato and -diolato species, a signature EPR spectrum has been predicted for each oxoCr(V)-I or -II linkage isomer, with defining g(iso) and (1)H a(iso) values and signal multiplicities. At pH values > 7.0, the major EPR signal (g(iso) approximately 1.980) is a septet, indicating the presence of oxoCr(V)-I or oxoCr(V)-II species with coordination from two O(8),O(9)-diolato(2-) chelates, with six magnetically equivalent protons ((1)H a(iso) approximately 0.7 x 10(-)(4) cm(-)(1)). At pH values < 7.0, where carboxylato binding competes with diolato binding, the species (g(iso) approximately 1.979) most likely feature mixed binding modes from one diolato(2-) and one tert-2-hydroxycarboxylato(2-) chelate (oxoCr(V)-II) or one diolato(2-) chelate, one monodentate carboxylato(1-) group, and aqua and/or hydroxo oxygen donors (oxoCr(V)-I). In I and II, the relative concentration of the oxoCr(V) linkage isomer featuring donation via the O(7),O(8) diolato group is about 1 order of magnitude smaller than the concentration of the O(8),O(9) linkage isomer. The dominance of oxoCr(V)-I or -II linkage isomers with O(8),O(9) donation correlates with the dihedral angle in these isomers (O(9)-C(9)-C(8)-O(8) approximately 65 degrees ) being more favorably disposed toward metal binding, as compared to the O(7),O(8) analogue (O(7)-C(7)-C(8)-O(8) approximately 163 degrees ). These results have important implications with respect to the nature of the oxoCr(V) species that may potentially form in the sialoglycoconjugate-rich environment of the human respiratory tract upon inhalation of carcinogenic Cr(VI) compounds.

Carcinogens, Environmental↗

PubMedDate not supplied

Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trial.

OBJECTIVE: To investigate the safety and efficacy of 2 extracts of echinacea for preventing upper respiratory tract infections. DESIGN: Three-armed, randomized, double-blind, placebo-controlled trial. SETTING: Four military institutions and 1 industrial plant. PARTICIPANTS: Three hundred two volunteers without acute illness at time of enrollment. INTERVENTIONS: Ethanolic extract from Echinacea purpurea roots, Echinacea angustifolia roots, or placebo, given orally for 12 weeks. MAIN OUTCOME MEASURE: Time until the first upper respiratory tract infection (time to event). Secondary outcome measures were the number of participants with at least 1 infection, global assessment, and adverse effects. RESULTS: The time until occurrence of the first upper respiratory tract infection was 66 days (95% confidence interval [CI], 61-72 days) in the E angustifolia group, 69 days (95% CI, 64-74 days) in the E purpurea group, and 65 days (95% CI, 59-70 days) in the placebo group (P = .49). In the placebo group, 36.7% had an infection. In the treatment groups, 32.0% in the E angustifolia group (relative risk compared with placebo, 0.87; 95% CI, 0.59-1.30) and 29.3% in the E purpurea group (relative risk compared with placebo, 0.80; 95% CI, 0.53-1.31) had an infection. Participants in the treatment groups believed that they had more benefit from the medication than those in the placebo group (P = .04). Adverse effects were reported by 18 subjects in the E angustifolia group, 10 in the E purpurea group, and 11 in the placebo group. CONCLUSION: In this study a prophylactic effect of the investigated echinacea extracts could not be shown. However, based on the results of this and 2 other studies, one could speculate that there might be an effect of echinacea products in the order of magnitude of 10% to 20% relative risk reduction. Future studies with much larger sample sizes would be needed to prove this effect.

Adult↗

PubMed1988

Enoxacin in the treatment of lower respiratory tract infections.

Twenty patients admitted to hospital with serious lower respiratory tract infections entered an open study of 400 mg enoxacin given orally twice a day for a minimum of seven days. Clinical signs and symptoms were completely cured or improved in six of eight patients with pneumonia, in nine of ten patients with bronchitis, and in two patients with bronchiectasis. Enoxacin was effective in eradicating the initial pathogens in 10 of 12 patients with positive cultures. Enoxacin was well tolerated. Only one treatment-related side-effect was observed during the study. Nine patients received concurrent treatment with theophylline, but no signs of theophylline toxicity were seen. Enoxacin is a safe and effective alternative to parenteral treatment of lower respiratory tract infections.

Acute Disease↗

PubMedDate not supplied

Flurithromycin ethylsuccinate in the treatment of lower respiratory tract bacterial infections.

Efficacy and tolerability of flurithromycin ethylsuccinate were evaluated in lower respiratory tract infections. One hundred and ten patients (38 women, 72 men; age range 18-87 years) were treated with on 375 mg tablet 12-hourly for a mean duration of 8.7 days. One hundred and five patients were evaluable for efficacy. Overall clinical cure rate was 62.9%; improvement was recorded in 19% of patients for a total satisfactory clinical response rate of 81.9%. Sputum production decreased in most patients, being absent after treatment in 47% (only one patient was negative at baseline); sputum was purulent or mucopurulent in 80% of subjects before and in 20% after treatment. Bacteriological evaluation was possible in 72 patients: pathogen eradication was achieved in 80.2% of cases. Eight patients out of 110 reported adverse reactions, mainly gastrointestinal; in one case treatment had to be discontinued. These results demonstrate that flurithromycin ethylsuccinate is safe and effective in the treatment of lower respiratory tract infections.

Acute Disease↗

PubMed1988

Blinded comparison of cefuroxime to cefaclor for lower respiratory tract infections.

Cefuroxime axetil was compared with cefaclor for the therapy for lower respiratory tract infections. Sixty-one patients were randomized to receive the following drug dosages: (1) cefuroxime axetil, 250 mg orally every 12 hours (21 patients); (2) cefuroxime axetil, 500 mg orally every 12 hours (21 patients); and (3) cefaclor, 500 mg orally every eight hours (19 patients). Of these 61 patients, 80% were male, with a mean age of 59.5 years; 56% had acute pneumonia, and the remainder had an acute bronchitis. Causative pathogens included typical respiratory tract pathogens. Overall, 23 of 27 patients with bronchitis were clinically cured at the end of therapy. Thirty-one of 34 pneumonias were clinically cured or improved at the end of therapy; the three pneumonia treatment failures occurred in the lower dose cefuroxime (n = 2) and cefaclor (n = 1) treatment groups. Overall, bacteriologic cure occurred in 86% of patients treated with 500 mg of cefuroxime axetil compared with 60% of cefaclor-treated patients. Adverse clinical effects were uncommon. From this study, it was concluded that cefuroxime given every 12 hours is at least as clinically efficacious as cefaclor; it is a new oral cephalosporin with pharmacologic and bacterial spectrum advantages over many older agents.

Acute Disease↗

PubMed1995

The influence of upper respiratory tract inflammation upon tubal function.

Eustachian tube function was examined in four patients (four ears) with a traumatic perforation of the tympanic membrane when they suffered from an upper respiratory tract (URT) infection or seasonal nasal allergy and after they had recovered. Although the tubal opening pressure did not show a distinct difference on the two occasions, the active ventilatory function was apparently impaired during the upper respiratory tract inflammation; particularly the negative middle ear pressure equalizing function, and was still impaired 2-3 weeks later after recovery from the upper respiratory tract inflammation. It is concluded that URT inflammation can affect tubal ventilatory function even in normal individuals.

Adult↗

PubMed1995

A comparison of ampicillin/sulbactam versus cefotaxime in the therapy of lower respiratory tract infections in hospitalized patients.

Fifty-three hospitalized patients suffering from lower respiratory tract infections were evaluated in a randomized, comparative trial studying the safety and efficacy of ampicillin/sulbactam (2 g ampicillin plus 1 g sulbactam intravenously every 6 h) versus cefotaxime (2 g intravenously every 6 h). Thirty-four of the 36 and 16 of the 17 patients treated with ampicillin/sulbactam and cefotaxime, respectively, were evaluable. Clinical and bacteriologic efficacy did not differ significantly between the two treatment groups (p = 0.828 and p = 0.648, respectively). Twenty-one (61.8%) of the ampicillin/sulbactam-treated patients were cured, eight (23.5%) improved and four (11.8%) were treatment failures. Nine (56.3%) of the cefotaxime treated patients were cured, four (25.0%) improved and two (12.5%) failed therapy. All primary pathogens were eradicated in 19 (55.9%) of the ampicillin/sulbactam group and were partially eradicated in seven (20.6%) patients. In the cefotaxime treatment group bacteriologic eradication occurred in 10 (62.5%) and partial eradication in two (12.5%) patients. Both study drugs were well tolerated, as the number of adverse reactions in each treatment group was small and similar between the two groups. Ampicillin/sulbactam appears to be as safe and effective as cefotaxime in the therapy of hospitalized patients with lower respiratory tract infections caused by beta-lactamase positive and beta-lactamase negative pathogens.

Adult↗

PubMedDate not supplied

Treatment of lower respiratory tract infections with amoxycillin/clavulanic acid in adults.

Patients with lower respiratory tract infections [pneumonia (n = 16), bronchiectasis (n = 5) and acute exacerbations of chronic bronchitis (n = 44)] were treated daily with amoxycillin/clavulanic acid given either 1.2 g intravenously three times daily or 625 mg orally three times daily for 7-15 days. Symptoms, signs and sputum volume and colour were monitored daily. Chest X-ray, sputum culture and Gram-stain examinations were also carried out on days 1 and 5, and immediately after the end of the treatment. There was a clinical improvement, as indicated by the incidence of cough, dyspnoea and rales, and by sputum volume and colour in 90.8% of the patients. Microbiological improvement, as indicated by the complete elimination of sputum pathogens and pus cells, was achieved in the same proportion of patients (90.8%). In one patient, an adverse side-effect, diffuse exanthema, was noted. Amoxycillin/clavulanic acid possesses a high clinical and microbiological efficacy for lower respiratory tract infections.

Administration, Oral↗

PubMed1996

Safety profile of sparfloxacin in the treatment of respiratory tract infections.

A total of 2081 adult patients with community-acquired lower respiratory tract infections participated in Phase III clinical trials of sparfloxacin. A total of 1040 patients were randomised to sparfloxacin and 1041 patients received a comparator regimen. Sparfloxacin was administered as a 400 mg loading dose on day 1 followed by 200 mg once daily to patients with community-acquired pneumonia and as a 200 mg loading dose on day 1 followed by 100 mg daily to patients with acute exacerbations of chronic obstructive pulmonary disease. Comparator regimens were amoxycillin/clavulanic acid 500/125 mg tid, amoxycillin 1000 mg tid, a combination of amoxycillin 1000 mg tid plus ofloxacin 200 mg bid or erythromycin 1000 mg bid. The incidence of adverse events, the incidence and severity of antibacterial-related adverse events and the incidence of antibacterial discontinuation due to adverse events were no different among patients treated with sparfloxacin compared with those who received a comparator antibacterial agent. Sparfloxacin appears to be as well tolerated as other oral antibacterial regimens commonly used to treat lower respiratory tract infections.

Adult↗

PubMed1994

Histopathology and cell replication responses in the respiratory tract of rats and mice exposed by inhalation to glutaraldehyde for up to 13 weeks.

In addition to being a respiratory tract irritant and cross-linking agent, glutaraldehyde has a number of properties in common with the rodent nasal carcinogen, formaldehyde. The acute and subchronic responses to glutaraldehyde in the respiratory tract of rats and mice were characterized using histopathology and epithelial cell labeling index as end points. Male and female F344 rats and B6C3F1 mice were whole-body exposed for 1 day, 4 days, 6 weeks, or 13 weeks to 0, 62.5, 125, 250, 500, or 1000 ppb glutaraldehyde using a recycling inhalation chamber. The respiratory tract, with special reference to the nose, was examined by light microscopy and histoautoradiography. Unit length labeling index (ULLI) was determined by nuclear thymidine labeling for selected sites, chosen on the basis of histopathology. A small number of animals exposed to 1000 ppb (rats and mice) or 500 ppb (mice) died before the 6-week time point; these deaths were attributed to glutaraldehyde exposure-associated occlusion of the external nares. Treatment-induced lesions, including epithelial erosions, inflammation, and squamous metaplasia, were confined to the anterior third of the nose and were present in both sexes and species. No histopathological evidence of glutaraldehyde-induced responses was observed in the trachea, central airways, or lungs, while the larynx showed minimal changes. There were clear increases in ULLI in association with acute and subacute cytotoxic responses, with similar concentration-response relationships. Neutrophilic infiltration of the squamous epithelium of the nasal vestibule, present in both rats and mice, became progressively more severe with increasing exposure time and was associated with increased ULLI. The latter responses were generally most severe at the higher glutaraldehyde exposure concentrations, while in female mice they were present at all concentrations of glutaraldehyde studied. Lesions induced by glutaraldehyde were more anterior in the nose than those reported for formaldehyde, they differed in character, and no evidence of "pre-neoplastic" lesions or karyomegaly, reported for formaldehyde, was observed with glutaraldehyde.

Administration, Inhalation↗

PubMed2002

Relationship of vitamin E supplementation and antimicrobial treatment with acute-phase protein responses in cattle affected by naturally acquired respiratory tract disease.

OBJECTIVE: To correlate serum concentrations of fibrinogen (Fib), haptoglobin (Hap), serum amyloid-A (SAA), and alpha-1 acid glycoprotein (AGP) with clinical respiratory tract disease and response to treatment in transport-stressed feedlot cattle fed vitamin E-supplemented diets. ANIMALS: 387 heifer calves (mean initial weight, 197 kg). PROCEDURE: Calves purchased from an order buyer were delivered to a feedlot to study the effects of dietary supplementation with 2,000 IU of vitamin E for 0, 7, 14, or 28 days after arrival. Serum or plasma Fib, Hap, SAA, and AGP concentrations were measured on days 0, 7, and 28 after arrival as well as at the time of treatment for respiratory tract disease with antimicrobial drugs and after completion of treatment. RESULTS: Vitamin E supplementation was associated with decreased treatment costs. In cattle that were not recognized as sick or responded positively to 1 antimicrobial treatment, serum Hap concentrations were significantly lower on days 0 and 7 than concentrations for cattle that required > 1 treatment. Serum Hap concentrations and ratios of Hap to SAA on day 0 significantly correlated with the number of antimicrobial treatments required. Serum Hap concentrations at the time of initial treatment were significantly lower for cattle that required only 1 treatment, compared with those that required > 1 treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Serum Hap concentrations are of potential value for use in assessing feedlot cattle that may become ill as a result of respiratory tract disease and for use in monitoring treatment efficacy.

Acute-Phase Proteins↗

PubMed2006

[The value of spiral CT scan to diagnose the respiratory tract foreign body with negative chest X-rays].

OBJECTIVE: To study the value of spiral CT scan in diagnosis of the respiratory tract foreign body in children. METHOD: Eighty-four patients with negative chest X-rays who were considered to have respiratory tract foreign body were done chest spiral CT scans. RESULT: All cases were found foreign body under spiral CT scans. CONCLUSION: Spiral CT scan is a special and valuable diagnostic method for respiratory tract foreign body. It can make up for the lack of chest X-rays.

Child↗

PubMed1992

Disk diffusion antimicrobial assays of agents used in respiratory tract infections in intubated patients admitted to the intensive care unit (ICU) of Kenyatta National Hospital from November to December 1990.

Sensitivity patterns of bacterial isolates from respiratory tract infections to benzylpenicillin, gentamicin and ceftazidime were studied. In a period covering 8 weeks from November to December 1990, tracheal aspirates from a total of 22 intubated patients aged 6-54 years were taken. The duration of stay of patients in the unit by the time of specimen collection ranged from 2-92 days. Respiratory tract infections by pathogenic organisms set in earliest on day 4. Elevated temperatures (equal to or greater than 38 degrees C) and/or purulence in sputum were used as diagnostic indicators of respiratory tract infections. A total of 12 pathogenic organisms were obtained: Proteus spp, Pseudomonas spp, Klebsiella spp, Acinetobacter spp, Escherichia coli and Staphylococcus aureus. None of the 12 pathogens isolated was sensitive to benzylpenicillin; 50% of organisms were sensitive to gentamicin and all were sensitive to ceftazidime.

Adolescent↗

PubMed1982

Bacterial cultures of the lower respiratory tract in normal volunteers with and without experimental rhinovirus infection using a plugged double catheter system.

To test a method of obtaining specimens for microbiologic culture from the lower respiratory tract, we bronchoscoped 25 otherwise normal subjects with and without experimental rhinovirus infections and collected specimens for bacterial culture with a brush housed in a plugged double catheter apparatus. Fifty-two specimens of the lower respiratory tract were obtained from the 25 subjects; nasopharyngeal swabs were also obtained from each subject prior to bronchoscopy. Specimens obtained from the lower respiratory tract were positive for bacteria in 21 (84%) of 25 subjects and at 38 (73%) of 52 sites. The frequency of obtaining positive bacterial cultures was similar in volunteers with (69%) or without (90%) rhinovirus infection. Oropharyngeal contamination of bronchial specimens was minimized by administering atropine and by bronchoscoping subjects in the supine or Trendelenburg position. These data indicate that the plugged double catheter brush system does not consistently yield specimens that are free of bacterial contamination from the oropharynx.

Adolescent↗

PubMed2004

The Use of Ketolides in Treatment of Upper Respiratory Tract Infections.

Recent surveillance studies suggest that the incidence of resistance to macrolide antibiotics in common community-acquired respiratory tract pathogens, particularly Streptococcus pneumoniae and Streptococcus pyogenes, is increasing and limiting the usefulness of these drugs. The ketolides, of which telithromycin is the first to be available for clinical use (but not yet in the United States), represent a new class of antibacterials developed specifically to combat respiratory tract pathogens that have acquired resistance to macrolides. The ketolides possess innovative structural modifications, a 3-keto group and a large N-substituted C11, C12-carbamate side chain. This novel structure allows ketolides, which are inhibitors of protein synthesis, to exert a more effective interaction with domain II of the 23S rRNA, enhancing binding to bacterial ribosomes and allowing binding to macrolide-lincosamide-streptogramin B-resistant ribosomes. This novel chemical structure also promotes greater stability of telithromycin in acid conditions, providing the potential for greater stability in gastric fluid and at cellular/tissue levels. Early clinical trials support the bacteriologic and clinical efficacy of telithromycin in the treatment of upper respiratory tract infections (RTIs) such as streptococcal pharyngitis and acute sinusitis, including infections caused by macrolide-resistant S. pneumoniae and S. pyogenes. Common adverse side effects associated with telithromycin are predominantly gastrointestinal, usually of mild to moderate severity, and rarely involve withdrawal of the drug. Telithromycin represents an attractive option for the empiric treatment of upper RTIs, especially as resistance to macrolides is likely to continue to increase.

Journal Article↗