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The ketolides: a critical review.
George G Zhanel1, Michael Walters, Ayman Noreddin
1Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. ggzhanel@pcs.mb.ca
Drugs
|August 1, 2002
Summary
Ketolides are a novel class of antibiotics effective against resistant respiratory pathogens. They offer potent protein synthesis inhibition and excellent activity against drug-resistant Streptococcus pneumoniae.
Area of Science:
- Pharmacology
- Microbiology
- Infectious Diseases
Background:
- Ketolides represent a new class of macrolide antibiotics.
- They are semi-synthetic derivatives of erythromycin A, modified to combat macrolide-resistant respiratory pathogens.
Purpose of the Study:
- To evaluate the efficacy and safety of ketolides as a new class of antibiotics.
- To assess their activity against resistant bacterial strains, particularly Streptococcus pneumoniae.
Main Methods:
- Review of clinical trial data for ketolides, focusing on telithromycin.
- Analysis of in vitro activity, pharmacokinetic profiles, and pharmacodynamic properties.
- Comparison with existing macrolide antibiotics.
Main Results:
- Ketolides demonstrate potent inhibition of bacterial protein synthesis.
- They exhibit excellent activity against drug-resistant Streptococcus pneumoniae and other respiratory pathogens.
- Pharmacokinetic profiles support once-daily dosing, with good tissue distribution.
- Clinical trials show efficacy in treating respiratory infections, with cure rates similar to comparators.
Conclusions:
- Ketolides are effective agents for treating respiratory tract infections, including those caused by resistant strains.
- Their favorable pharmacokinetic and pharmacodynamic properties, along with a comparable safety profile to newer macrolides, position them as valuable therapeutic options.
- The role of ketolides will be influenced by resistance patterns, adverse effects, drug interactions, and cost.