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Published on: January 2, 2017

Effect of telithromycin and azithromycin on nasopharyngeal bacterial flora in patients with acute maxillary sinusitis

Itzhak Brook1, Jeffrey N Hausfeld

  • 1Department of Pediatrics and Medicine, Georgetown University School of Medicine, Washington, DC, USA. ib6@georgetown.edu

Archives of Otolaryngology--Head & Neck Surgery
|April 19, 2006
PubMed
Abstract

Insights

Telithromycin demonstrated superior efficacy over azithromycin in eradicating Streptococcus pneumoniae from the nasopharynx in adults with acute maxillary sinusitis, showing a significant reduction in resistant pneumococcal isolates.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Increasing resistance of Streptococcus pneumoniae to penicillin and macrolides necessitates novel therapeutic agents.
  • Ketolides represent a new class of antibiotics effective against drug-resistant pneumococci.

Purpose of the Study:

  • To compare the efficacy of ketolide telithromycin versus azithromycin in eradicating Streptococcus pneumoniae from the nasopharynx.
  • To evaluate the impact of these antibiotics on antibiotic resistance in key pathogens associated with acute maxillary sinusitis.

Main Methods:

  • A clinical study involving 105 adult patients diagnosed with acute maxillary sinusitis.
  • Patients received either azithromycin (500 mg daily for 3 days) or telithromycin (800 mg daily for 5 days).
  • Nasopharyngeal cultures were obtained pre-treatment and 10-12 days post-treatment to assess pathogen eradication and resistance development.

Main Results:

  • Telithromycin achieved a 94% reduction in Streptococcus pneumoniae isolates, compared to a 43% reduction with azithromycin (P < .01).
  • Post-treatment, only one S. pneumoniae isolate remained in the telithromycin group, which was susceptible to both agents.
  • Azithromycin treatment resulted in 5 of 8 remaining S. pneumoniae isolates being resistant, and resistance development was observed only in the azithromycin group (P < .05).

Conclusions:

  • Telithromycin exhibits superior efficacy compared to azithromycin for the eradication of nasopharyngeal Streptococcus pneumoniae.
  • Telithromycin may be a more effective option in managing acute maxillary sinusitis, particularly in the context of rising antibiotic resistance.

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