Tags: ketolide

Specific Anti-Infective Agents

Clinicians should be familiar with the general classes of antibiotics, their mechanisms of action, and their major toxicities. The differences between the specific antibiotics in each class can be subtle, often requiring the expertise of an infectious disease specialist to design the optimal anti-infective regimen. The general internist or physician-in-training should not attempt to memorize all the facts outlined here, but rather should read the pages that follow as an overview of anti-infectives. The chemistry, mechanisms of action, major toxicities, spectrum of activity, treatment indications, pharmacokinetics, dosing regimens, and cost are reviewed.

Community-Acquired Pneumonia: Current Therapies

Many highly effective agents are available for the treatment of bacterial community-acquired pneumonia (community-acquired pneumonia) and other community-acquire respiratory tract infections (RTIs). Currently marketed antibiotics for community-acquired pneumonia demonstrate similar efficacy rates in clinical trials, and these agents have generally achieved clinical symptom resolution in 85-95% of trial participants.

Antibiotics and Antibiotic Resistance

Antimicrobial resistance in Streptococcus pneumoniae and other community-acquired pneumonia pathogens has progressed at an alarming rate. Approximately one-third of pneumococci exhibit reduced susceptibility to penicillin (i.e., higher MICs) that also confers reduced susceptibility to other agents in the β-lactam class of antibiotics. Macrolide resistance levels range between 23% and 30% in the United States, and much higher levels are observed in some other markets. N.

Ketolides – New Class of Macrolide Derivatives

Ketolides are a new class of macrolide derivatives designed specifically to combat macrolide-resistant respiratory tract pathogens. The ketolides exhibit good activity against gram-positive and some gram-negative organisms and have excellent activity against drug-resistant S. pneumoniae, including macrolide-resistant strains. Spontaneous resistance to the available ketolide, telithromycin, is rare. Ketolides display excellent pharmacokinetics that allow once-daily dose administration and extensive tissue distribution relative to serum.

Ketolides

Ketolides are a new class of macrolide derivatives designed specifically to combat macro fide-resistant respiratory tract pathogens. The ketolides are semisynthetic derivatives of the macrolide erythromycin A, with a keto group replacing the 1-cladinose group at position 3 of the macrolactone ring. The ketolides exhibit good activity against gram-positive and some gram-negative organisms, and have excellent activity against drug-resistant S. pneumoniae, including macrolide-resistant strains.

Acute Exacerbations of Chronic Bronchitis: Current therapies

TABLE: Pharmacological Management of Underlying Disease During an Acute Exacerbation of Chronic Bronchitis summarizes the general pharmacological agents and classes used to manage acute exacerbations of chronic bronchitis. The primary therapies used in acute exacerbations of chronic bronchitis treat the causative infection (antibiotics), relieve symptoms (bronchodilators), and treat the underlying inflammation (corticosteroids). TABLE: Current Therapies Used for Acute Exacerbations of Chronic Bronchitis summarizes the leading antibiotic therapies used to treat the infection.

Telithromycin

Diarrhoea and other gastrointestinal disturbances such as nausea, vomiting, abdominal pain, and flatulence are among the most common adverse reactions after use of telithromycin. Severe, but usually reversible, hepatic dysfunction, including elevation of liver enzymes and hepatitis, with or without jaundice has been reported; however, there have been cases of fatal hepatotoxicity including fulminant hepatitis, hepatic necrosis, and hepatic failure.

Case: Antibacterial agents. Questions – Answers

Which of the following is the most likely explanation for multiple drug resistance to antibiotics that spreads from one type of bacteria to another? Penicillins inhibit which of the following bacterial processes/ compounds? Ototoxicity and nephrotoxicity are characteristic adverse effects of which of the following?