Telithromycin is rapidly absorbed after oral administration, regardless of the food intake and metabolised primarily in the liver.
Telithromycin is a Ketolidantibiotikum. Ketolides are chemically with the macrolides (macrolides) and related inhibit ribosomal protein synthesis without causing a resistance to macrolides, clindamycin or streptomycin. Telithromycin can have serious side effects and should not be selected as a rule, when other less toxic alternatives are available. Telithromycin is rapidly absorbed after oral administration, regardless of the food intake and metabolised primarily in the liver. Indications telithromycin is effective against erythromycin-susceptible staphylococci and streptococci and multidrug-resistant Streptococcus pneumoniae. Telithromycin is also effective against erythromycin-sensitive enterococci, Bordetella pertussis, Haemophilus influenzae, Helicobacter pylori, Moraxella catarrhalis, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella, Prevotella and Peptostreptococcus spp. Because of security concerns telithromycin is community-acquired easily recommended for the treatment of adults ? 18 years to moderate pneumonia because of the following pathogens:. S. pneumoniae (including multidrug-resistant strains, that is penicillin-resistant S. pneumoniae; isolates resistant ? 2 the following means are resistant: penicillin, cephalosporins second-generation [eg cefuroxime.], macrolides, tetracyclines, trimethoprim / sulfamethoxazole) H. influenzae M. catarrhalis C. pneumoniae M. pneumoniae contraindications Contraindications: myasthenia gravis because telithromycin can exacerbate symptoms and has occurred in some patients with this disorder fatal respiratory arrest. Past allergic reaction to telithromycin or macrolide Past hepatitis or jaundice after taking telithromycin or a macrolide Concomitant use of pimozide or cisapride because of cardiac arrhythmias (QT prolongation, ventricular tachycardia, ventricular fibrillation, torsades de pointes) Co-administration of colchicine in patients with kidney or liver dysfunction clinical calculator: QT interval correction (ECG) use during pregnancy and lactation telithromycin is in pregnancy category C because animal studies show some risk, notes are not sufficiently in human studies, but sometimes the clinical benefit the risk predominates. Safety of telithromycin during lactation is not known. Side effects Side effects include GI disorders QT interval prolongation Severe Hepatitis diarrhea, nausea, vomiting and dizziness are the most common adverse effects. Prolongation of the QT interval, hyperbilirubinemia, elevated liver enzymes, transient loss of consciousness (sometimes with Vagussyndrom) and blurred vision (especially a slowed ability to accommodate and relax again) are less common. Because fainting or vision problems pose a risk, patients should try to avoid potentially hazardous activities (eg. As driving a car, operating dangerous equipment). Severe liver damage may require a liver transplant and be fatal. There may be cross sensitivities macrolides. Considerations for dosing telithromycin inhibits cytochrome P-450 (CYP450) 3A4, and can mirror the following medications increase: Digoxin Digoxin side effects or serum levels should be monitored. Ergot alkaloids: Concomitant use should be avoided. Benzodiazepines: When co-administered with caution. Metoprolol: In patients with heart failure Caution should be exercised when co-administered. Statins: The concomitant use of simvastatin, lovastatin, or atorvastatin (but not pravastatin or fluvastatin) should be avoided. Cisapride: Concomitant use is contraindicated. Pimozide: Concomitant use is contraindicated. Sirolimus tacrolimus CYP3A4 inducers such. As rifampicin, phenytoin, carbamazepine, phenobarbital and lower the Telithromycinspiegel; CYP3A4 inhibitors ketoconazole and itraconazole increase the Telithromycinspiegel. Telithromycin decreases absorption of sotalol.