Efficacy of telithromycin in community-acquired pneumonia caused by pneumococci with reduced susceptibility to penicillin and/or erythromycin

Abstract

Background: The efficacy of oral telithromycin was assessed in patients with community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae with reduced susceptibility to penicillin and/or erythromycin.

Methods: Patients with CAP who had received telithromycin 800 mg once daily for 5 or 7-10 days (n = 2,289) in eight phase III clinical trials, or telithromycin 800 mg once daily for 7 days (n = 50) in a phase II study were included in this pooled analysis. Patients with S. pneumoniae as the cause of infection were identified, with particular focus on those infected with strains with reduced susceptibility to penicillin (intermediate, minimal inhibitory concentration (MIC) 0.12-1.0 mg/l; resistant, MIC >or=2.0 mg/l) and/or resistance to erythromycin (MIC >or=1.0 mg/l). Per-protocol clinical and bacteriological outcomes were assessed 7-14 days post-therapy in the phase III studies, and at 7-21 days post-therapy or at the end of therapy in the phase II study.

Results: Of the 327 telithromycin-treated patients with S. pneumoniae infection, 61 (19%) were infected with strains with reduced susceptibility to penicillin and/or erythromycin. Clinical cure and bacterial eradication rates in these patients were 91.8% (56/61) and 93.4% (57/61), respectively. Corresponding clinical cure and bacterial eradication rates overall for all isolates of pneumococci were 94.5% (309/327) and 96.0% (314/327), respectively. All isolates with reduced susceptibility to penicillin and/or erythromycin were susceptible to telithromycin (MIC <or=1.0 mg/l).

Conclusion: These results indicate that telithromycin is an effective oral antibacterial for the treatment of CAP caused by pneumococci with reduced susceptibility to penicillin and/or erythromycin.