Drug Safety

, Volume 31, Issue 7, pp 561–575 | Cite as

Benefit-Risk Assessment of Telithromycin in the Treatment of Community-Acquired Pneumonia

  • Steven D. Brown
Review Article


The purpose of this review is to assess the benefits and risks associated with the use of the ketolide antibacterial telithromycin, currently licensed for the treatment of adults with mild to moderate community-acquired pneumonia (CAP). Telithromycin is active against both the major (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) and atypical/intracellular (Chlamydophila pneumoniae, Legionella pneumophila and Mycoplasma pneumoniae) CAP pathogens. It is associated with a low potential to select for resistance and has maintained its in vitro activity against isolates of respiratory pathogens in countries where it has been in clinical use for several years. In randomized clinical trials, telithromycin has demonstrated efficacy comparable to the established antibacterial classes (macrolides, fluoroquinolones and β-lactams) in the treatment of CAP.

The safety profile of telithromycin is broadly similar to that of other antibacterials used to treat CAP. The most common adverse events are gastrointestinal adverse effects and headache; these are generally mild to moderate in severity and reversible. Telithromycin appears to be well tolerated by adult patients in all age groups, including those with co-morbid conditions. In common with other anti-bacterials, telithromycin has the potential to affect the corrected QT interval; the concomitant use of cisapride or pimozide with telithromycin is contraindicated, while telithromycin should be avoided in patients receiving Class LA or Class III antiarrhythmic drugs. Visual disturbances (usually transient) have occurred in a small proportion of patients treated with telithromycin; it is recommended that activities such as driving are minimized during treatment. Telithromycin is contraindicated in patients with myasthenia gravis. Hepatic dysfunction may occur in some patients taking telithromycin; rare cases of acute hepatic failure and severe liver injury, including deaths, have been reported.

As telithromycin is an inhibitor of the cytochrome P450 (CYP) 3A4 system, coadministration of telithromycin with drugs metabolized by this pathway may require dose adjustments (e.g. with benzodiazepines) or a temporary hiatus in the use of the coadministered drug (e.g. HMG-CoA reductase inhibitors) metabolized by CYP3A4. Telithromycin may potentiate the effects of oral anticoagulants; careful monitoring is recommended in patients receiving telithromycin and oral anticoagulants simultaneously.

Although serious and sometimes fatal events have occurred in patients receiving telithromycin therapy, current data indicate that telithromycin offers an acceptable benefit risk ratio in the treatment of mild to moderate CAP.


Clarithromycin Azithromycin Cisapride Severe Renal Impairment Pimozide 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used in the preparation of this article. The author has previously served on advisory boards for sanofi-aventis, and serves as an independent consultant on an ad hoc basis. Grant support for in vitro studies has been previously provided by sanofi-aventis. Editorial support has been provided by the US publications support group of sanofi-aventis.


  1. 1.
    Zhanel GG, Walters M, Noreddin A, et al. The ketolides: a critical review. Drugs 2002; 62: 1771–804PubMedCrossRefGoogle Scholar
  2. 2.
    Wellington K, Noble S. Telithromycin. Drugs 2004; 64: 1683–94PubMedCrossRefGoogle Scholar
  3. 3.
    Bonnefoy A, Girard AM, Agouridas C, et al. Ketolides lack inducibility properties of MLSB resistance phenotype. J Antimicrob Chemother 1997; 40: 85–90PubMedCrossRefGoogle Scholar
  4. 4.
    Douthwaite S. Structure-activity relationships of ketolides vs macrolides. Clin Microbiol Infect 2001; 7 Suppl. 3: 11–7PubMedCrossRefGoogle Scholar
  5. 5.
    Hansen LH, Mauvais P, Douthwaite S. The macrolide-ketolide antibiotic binding site is formed by structures of domain II and V of 23S ribosomal RNA. Mol Microbiol 1999; 31: 623–31PubMedCrossRefGoogle Scholar
  6. 6.
    Douthwaite S, Champney S. Structures of ketolides and macrolides determine their mode of interaction with the ribosomal target site. J Antimicrob Chemother 2001; 48 Suppl. T1: 1–8CrossRefGoogle Scholar
  7. 7.
    File TM. The epidemiology of respiratory tract infections. Semin Respir Infect 2000; 15: 184–94PubMedCrossRefGoogle Scholar
  8. 8.
    Niederman MS, Mandell LA, Anzueto A, et al. Guidelines for the management of adults with community-acquired pneumonia: diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 2001; 163: 1730–54PubMedCrossRefGoogle Scholar
  9. 9.
    Blasi F. Atypical pathogens and respiratory tract infections. Eur Respir J 2004; 24: 171–81PubMedCrossRefGoogle Scholar
  10. 10.
    Canton R. Resistance trends in Moraxella catarrhalis (PRO-TEKT years 1–3 [1999–2002]). J Chemother 2004; 16 Suppl. 6: 63–70PubMedGoogle Scholar
  11. 11.
    Dunbar LM. Current issues in the management of bacterial respiratory tract disease: the challenge of antibacterial resistance. Am J Med Sci 2003; 326: 360–8PubMedCrossRefGoogle Scholar
  12. 12.
    Jacobs MR, Bajaksouzian S, Windau A, et al. Susceptibility of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis to 17 oral antimicrobial agents based on pharmacodynamic parameters: 1998–2001 US Surveillance Study. Clin Lab Med 2004; 24: 503–30PubMedCrossRefGoogle Scholar
  13. 13.
    Jenkins SG, Farrell DJ, Patel M, et al. Trends in anti-bacterial resistance among Streptococcus pneumoniae isolated in the USA, 2000–2003: PROTEKT US years 1–3. J Infect 2005; 51: 355–63PubMedCrossRefGoogle Scholar
  14. 14.
    Mera RM, Miller RA, Daniels JJ, et al. Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States over a 10-year period: Alexander Project. Diagn Microbiol Infect Dis 2005; 51: 195–200PubMedCrossRefGoogle Scholar
  15. 15.
    Low DE. Resistance trends in Haemophilus influenzae (PRO-TEKT years 1–3 [1999–2002]). J Chemother 2004; 16 Suppl. 6: 49–62PubMedGoogle Scholar
  16. 16.
    Marchese A, Schito GC. Recent findings from multinational resistance surveys: are we “PROTEKTed” from resistance? Int J Antimicrob Agents 2007; 29 Suppl. 1: S2–5PubMedCrossRefGoogle Scholar
  17. 17.
    Reinert RR. Resistance phenotypes and multi-drug resistance in Streptococcus pneumoniae (PROTEKT years 1–3 [1999–2002]). J Chemother 2004; 16 Suppl. 6: 35–48PubMedGoogle Scholar
  18. 18.
    Dias R, Caniça M. Emergence of invasive erythromycin-resistant Streptococcus pneumoniae strains in Portugal: contribution and phylogenetic relatedness of serotype 14. J Antimicrob Chemother 2004; 54: 1035–9PubMedCrossRefGoogle Scholar
  19. 19.
    Klugman KP. Clinical impact of antibiotic resistance in respiratory tract infections. Int J Antimicrob Agents 2007; 29 Suppl. 1: S6–10PubMedCrossRefGoogle Scholar
  20. 20.
    Vanderkooi OG, Green DE, Low K, et al., for the Toronto Invasive Bacterial Disease Network. Predicting antimicrobial resistance in invasive pneumococcal infections. Clin Infect Dis 2005; 40: 1288–97PubMedCrossRefGoogle Scholar
  21. 21.
    Daneman N, McGeer A, Green K, et al. Toronto Invasive Bacterial Diseases Network. Macrolide resistance in bacteremic pneumococcal disease: implications for patient management. Clin Infect Dis 2006; 43: 432–8PubMedCrossRefGoogle Scholar
  22. 22.
    Bell D. Promoting appropriate antimicrobial drug use: perspective from the centers for disease control and prevention. Clin Infect Dis 2001; 33 Suppl. 3: S245–50PubMedCrossRefGoogle Scholar
  23. 23.
    Kastner U, Guggenbichler JP. Influence of macrolide antibiotics on promotion of resistance in the oral flora of children. Infection 2001; 29: 251–6PubMedCrossRefGoogle Scholar
  24. 24.
    Nicolau DP. Treatment with appropriate antibiotic therapy in community-acquired respiratory tract infections. Am J Manag Care 2004; 10 Suppl.: S381–8PubMedGoogle Scholar
  25. 25.
    Brixner DL. Clinical and economic outcomes in the treatment of lower respiratory tract infections. Am J Manag Care 2004; 10 12 Suppl.: S400–7Google Scholar
  26. 26.
    Zhanel GG, Dueck M, Hoban DJ, et al. Review of macrolides and ketolides: focus on respiratory tract infections. Drugs 2001; 61: 443–98PubMedCrossRefGoogle Scholar
  27. 27.
    Felmingham D, Farrell DJ. In vitro activity of telithromycin against gram-negative bacterial pathogens. J Infect 2006; 52: 178–80PubMedCrossRefGoogle Scholar
  28. 28.
    Weisblum B. Insights into erythromycin action from studies of its activity as inducer of resistance. Antimicrob Agents Chemother 1995; 39: 797–805PubMedCrossRefGoogle Scholar
  29. 29.
    Farrell DJ, Jenkins SG. Distribution across the USA of macrolide resistance and macrolide resistance mechanisms among Streptococcus pneumoniae isolates collected from patients with respiratory tract infections: PROTEKT US 2001–2002. J Antimicrob Chemother 2004; 54 Suppl. 1: i17–22PubMedCrossRefGoogle Scholar
  30. 30.
    Farrell DJ, Jenkins SG, Brown SD, et al. Emergence and spread of Streptococcus pneumoniae with erm(B) and mef(A) resistance. Emerg Infect Dis 2005; 11: 851–8PubMedCrossRefGoogle Scholar
  31. 31.
    Namour F, Wessels DH, Pascual MH, et al. Pharmacokinetics of the new ketolide telithromycin (HMR 3647) administered in ascending single and multiple doses. Antimicrob Agents Chemother 2001; 45: 170–5PubMedCrossRefGoogle Scholar
  32. 32.
    Shi J, Montay G, Bhargava VO. Clinical pharmacokinetics of telithromycin, a new ketolide antibacterial. Clin Pharmacokinet 2005; 44: 915–34PubMedCrossRefGoogle Scholar
  33. 33.
    Cantalloube C, Bhargava V, Sultan E, et al. Pharmacokinetics of the ketolide telithromycin after single and repeated doses in patients with hepatic impairment. Int J Antimicrob Agents 2003; 22: 112–21PubMedCrossRefGoogle Scholar
  34. 34.
    Ciervo CA, Shi J. Pharmacokinetics of telithromycin: application to dosing in the treatment of community-acquired respiratory tract infections. Curr Med Res Opin 2005; 21: 1641–50PubMedCrossRefGoogle Scholar
  35. 35.
    Ketek® (telithromycin) tablets. Sanofi-aventis, 2007 [online]. Available from URL: [Accessed 2007 Oct 12]
  36. 36.
    Kardas P, Devine S, Golembesky A, et al. A systematic review and meta-analysis of misuse of antibiotic therapies in the community. Int J Antimicrob Agents 2005; 26: 106–13PubMedCrossRefGoogle Scholar
  37. 37.
    Nicolau DP. Clinical use of antimicrobial pharmacodynamic profiles to optimize treatment outcomes in community-acquired bacterial respiratory tract infections: application to telithromycin. Expert Opin Pharmacother 2004; 5: 229–35PubMedCrossRefGoogle Scholar
  38. 38.
    Muller-Serieys C, Andrews J, Vacheron F, et al. Tissue kinetics of telithromycin, the first ketolide antibacterial. J Antimicrob Chemother 2004; 53: 149–57PubMedCrossRefGoogle Scholar
  39. 39.
    Khair OA, Andrews JM, Honeybourne D, et al. Lung concentrations of telithromycin after oral dosing. J Antimicrob Chemother 2001; 47: 837–40PubMedCrossRefGoogle Scholar
  40. 40.
    Farrell DJ, Canton R, Hryniewicz W. Trends in antibacterial resistance of Streptococcus pneumoniae: PROTEKT global years 1–5. Clin Microbiol Infect 2006; 12 Suppl. 4: P1279Google Scholar
  41. 41.
    Nord CE, Farrell DJ, Leclercq R. Impact of ketolides on resistance selection and ecologic effects during treatment for respiratory tract infections. Microb Drug Resist 2004; 10: 255–63PubMedCrossRefGoogle Scholar
  42. 42.
    Capobianco JO, Cao Z, Shortridge VD, et al. Studies of the novel ketolide ABT-773: transport, binding to ribosomes and inhibition of protein synthesis in Streptococcus pneumoniae. Antimicrob Agents Chemother 2000; 44: 1562–7PubMedCrossRefGoogle Scholar
  43. 43.
    Lorenz J. Telithromycin: the first ketolide antibacterial for the treatment of community-acquired respiratory tract infections. Int J Clin Pract 2003; 57: 519–29PubMedGoogle Scholar
  44. 44.
    Stratton CW. Dead bugs don’t mutate: susceptibility issues in the emergence of bacterial resistance. Emerg Infect Dis 2003; 9: 10–6PubMedCrossRefGoogle Scholar
  45. 45.
    Farrell DJ, Felmingham D. The PROTEKT study year 4 demonstrates a continued lack of resistance development to telithromycin in Streptococcus pneumoniae. J Antimicrob Chemother 2005; 56: 795–7PubMedCrossRefGoogle Scholar
  46. 46.
    Goldstein F, Vidal B, Kitzis MD. Telithromycin-resistant Streptococcus pneumoniae. Emerg Infect Dis 2005; 11: 1489–90PubMedCrossRefGoogle Scholar
  47. 47.
    Rantala M, Haanpera-Heikkinen M, Lindgren M, et al. Streptococcus pneumoniae isolates resistant to telithromycin. Antimicrob Agents Chemother 2006; 50: 1855–8PubMedCrossRefGoogle Scholar
  48. 48.
    Hagberg L, Torres A, van Rensburg D, et al. Efficacy and tolerability of once-daily telithromycin compared with high-dose amoxicillin for treatment of community-acquired pneumonia. Infection 2002; 30: 378–86PubMedCrossRefGoogle Scholar
  49. 49.
    Mathers Dunbar L, Hassman J, Tellier G. Efficacy and tolerability of once-daily oral telithromycin compared with clarithromycin for the treatment of community-acquired pneumoniae in adults. Clin Ther 2004; 26: 48–62PubMedCrossRefGoogle Scholar
  50. 50.
    Tellier G, Niederman MS, Nusrat R, et al. Clinical and bacteriological efficacy and safety of 5 and 7 day regimens of telithromycin once daily compared with a 10 day regimen of clarithromycin twice daily in patients with mild to moderate community-acquired pneumonia. J Antimicrob Chemother 2004; 54: 515–23PubMedCrossRefGoogle Scholar
  51. 51.
    Pullman J, Champlin J, Vrooman Jr PS. Efficacy and tolerability of once-daily oral therapy with telithromycin compared with trovafloxacin for the treatment of community-acquired pneumonia in adults. Int J Clin Pract 2003; 57: 377–84PubMedGoogle Scholar
  52. 52.
    Mouton Y, Thamlikitkul V, Nieman RB, et al. Telithromycin versus other first-line single-agent antibiotics in the treatment of community-acquired pneumonia: a randomized superiority trial [abstract no. P883]. Abstracts of the 15th European Congress of Clinical Microbiology and Infectious Diseases; 2005 Apr 2–5; CopenhagenGoogle Scholar
  53. 53.
    Carbon C, Moola S, Velancsics I, et al. Telithromycin 800mg once daily for seven to ten days is an effective and well-tolerated treatment for community-acquired pneumonia. Clin Microbiol Infect 2003; 9: 691–703PubMedCrossRefGoogle Scholar
  54. 54.
    Fogarty CM, Patel TC, Dunbar LM, et al. Efficacy and safety of telithromycin 800mg once daily for 7 days in community-acquired pneumonia: an open-label, multicenter study. BMC Infect Dis 2005; 5: 43PubMedCrossRefGoogle Scholar
  55. 55.
    van Rensburg DJ, Fogarty C, Kohno S, et al. Efficacy of telithromycin in community-acquired pneumonia caused by pneumococci with reduced susceptibility to penicillin and/or erythromycin. Chemotherapy 2005; 51: 186–92PubMedCrossRefGoogle Scholar
  56. 56.
    Carbon C, van Rensburg D, Hagberg L, et al. Clinical and bacteriologic efficacy of telithromycin in patients with bacteremic community-acquired pneumonia. Respir Med 2006; 100: 577–85PubMedCrossRefGoogle Scholar
  57. 57.
    Buchanan PP, Stephens TA, Leroy B. A comparison of the efficacy of telithromycin versus cefuroxime axetil in the treatment of acute bacterial maxillary sinusitis. Am J Rhinol 2003; 17: 369–77PubMedGoogle Scholar
  58. 58.
    Luterman M, Tellier G, Lasko B, et al. Efficacy and tolerability of telithromycin for 5 or 10 days vs amoxicillin/clavulanic acid for 10 days in acute maxillary sinusitis. Ear Nose Throat J 2003; 82: 576–86PubMedGoogle Scholar
  59. 59.
    Ferguson BJ, Guzzetta RV, Specter SL, et al. Efficacy and safety of oral telithromycin once daily for 5 days versus moxifloxacin once daily for 10 days in the treatment of acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg 2004; 131: 207–14PubMedCrossRefGoogle Scholar
  60. 60.
    Zervos MJ, Heyder AM, Leroy B. Oral telithromycin 800mg once daily for 5 days versus cefuroxime axetil 500mg twice daily for 10 days in adults with acute exacerbations of chronic bronchitis. J Int Med Res 2003; 31: 157–69PubMedGoogle Scholar
  61. 61.
    Aubier M, Aidons PM, Leak A, et al. Telithromycin is as effective as amoxicillin/clavulanate in acute exacerbations of chronic bronchitis. Respir Med 2002; 96: 862–71PubMedCrossRefGoogle Scholar
  62. 62.
    Fogarty C, de Wet R, Mandell L, et al. Five-day telithromycin once daily is as effective as 10-day clarithromycin twice daily for the treatment of acute exacerbations of chronic bronchitis and is associated with reduced healthcare resource utilization. Chest 2005 128: 1980–8PubMedCrossRefGoogle Scholar
  63. 63.
    Niederman MS, McCombs JS, Unger AN, et al. The cost of treating community-acquired pneumonia. Clin Ther 1998; 20: 820–37PubMedCrossRefGoogle Scholar
  64. 64.
    Miravitlles M, Murio C, Guerrero T, et al. Pharmacoeconomic evaluation of acute exacerbations of chronic bronchitis and COPD. Chest 2002; 121: 1449–55PubMedCrossRefGoogle Scholar
  65. 65.
    Niederman MS, Chang JR, Stewart J, et al. Comparison of hospitalization rates in patients with community-acquired pneumonia treated with 10 days of telithromycin or clarithromycin. Curr Med Res Opin 2004; 20: 749–56PubMedCrossRefGoogle Scholar
  66. 66.
    Niederman MS, Chang JR, Stewart J, et al. Hospitalization rates among patients with community-acquired pneumonia treated with telithromycin vs clarithromycin: results from two randomized, double-blind, clinical trials. Curr Med Res Opin 2004; 20: 969–80PubMedCrossRefGoogle Scholar
  67. 67.
    US FDA. sanofi-aventis briefing document available for public disclosure Ketek® (telithromycin). December 14–15, 2006 Anti-infective Drugs Advisory Committee/Drug Safety and Risk Management Advisory Committee meeting 2006 Dec 14–15 [online]. Available from URL: [Accessed 2008 Jun 5]
  68. 68.
    Telithromycin briefing document for the FDA anti-infective drug product advisory meeting January 2003 [online]. Available from URL: [Accessed 2008 Jan 23]
  69. 69.
    Lonks JR, Goldmann DA. Telithromycin: a ketolide antibiotic for treatment of respiratory tract infections. Clin Infect Dis 2005; 40: 1657–64PubMedCrossRefGoogle Scholar
  70. 70.
    Démolis JL, Vacheron F, Cardus S, et al. Effect of single and repeated oral doses of telithromycin on cardiac QT interval in healthy subjects. Clin Pharmacol Ther 2003; 73: 242–52PubMedCrossRefGoogle Scholar
  71. 71.
    Clay KD, Hanson JS, Pope SD, et al. Brief communication: severe hepatotoxicity of telithromycin. Three case reports and literature review. Ann Intern Med 2006; 144: 415–20PubMedGoogle Scholar
  72. 72.
    Perrot X, Bernard N, Vial C, et al. Myasthenia gravis exacerbation or unmasking associated with telithromycin treatment. Neurology 2006; 67: 2256–8PubMedCrossRefGoogle Scholar
  73. 73.
    Jennett AM, Bali D, Jasti P, et al. Telithromycin and myasthenia crisis. Clin Infect Dis 2006; 43: 1621–2PubMedCrossRefGoogle Scholar
  74. 74.
    US Food and Drug Administration. Center for Drug Evaluation and Research. Telithromycin (marketed as Ketek) information [online]. Available from URL: [Accessed 2007 Oct 12]
  75. 75.
    Ross DB. The FDA and the case of Ketek. N Engl J Med 2007; 356: 1601–4PubMedCrossRefGoogle Scholar
  76. 76.
    Soreth J, Cox E, Kweder S, et al. Ketek: the FDA perspective. N Engl J Med 2007; 356: 1675–6PubMedCrossRefGoogle Scholar
  77. 77.
    European Medicines Agency discussion document 30 Mar 2007 [online]. Available from URL: [Accessed 2008 Jan 23]
  78. 78.
    Pfizer. Zithromax®. Pfizer Labs, 2003 [online]. Available from URL: [Accessed 2007 Oct 12]
  79. 79.
    Abbott Laboratories. Biaxin® and Biaxin XL®. Abbott Laboratories, 2005 [online]. Available from URL:,050698s020,050775s008lbl.pdf [Accessed 2007 Oct 12]
  80. 80.
    Dore DD, DiBello JR, Lapane KL. Telithromycin use and spontaneous reports of hepatotoxicity. Drug Saf 2007; 30: 697–703PubMedCrossRefGoogle Scholar
  81. 81.
    Shi J, Montay G, Chapel S, et al. Pharmacokinetics and safety of the ketolide telithromycin in patients with renal impairment. J Clin Pharmacol 2004; 44: 234–44PubMedCrossRefGoogle Scholar
  82. 82.
    Perret C, Lenfant B, Weinling E, et al. Pharmacokinetics and absolute oral bioavailability of an 800-mg oral dose of telithromycin in healthy young and elderly volunteers. Chemotherapy 2002; 48: 217–23PubMedCrossRefGoogle Scholar
  83. 83.
    Tinel M, Descatoire V, Larrey D, et al. Effects of clarithromycin on cytochrome P-450: comparison with other macrolides. J Pharmacol Exp Ther 1989; 250: 746–51PubMedGoogle Scholar
  84. 84.
    Michalets EL, Williams CR. Drug interactions with cisapride: clinical implications. Clin Pharmacokinet 2000; 39: 49–75PubMedCrossRefGoogle Scholar
  85. 85.
    Bellosta S, Paoletti R, Corsini A. Safety of statins: focus on clinical pharmacokinetics and drug interactions. Circulation 2004; 109 Suppl. 1: III50–7PubMedCrossRefGoogle Scholar
  86. 86.
    Montay G, Chevalier P, Guimart C, et al. A 12-hour dosing interval reduces the pharmacokinetic interaction between telithromycin and simvastatin [abstract A-1623]. Abstracts of the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy; 2003 Sep 14–17; Chicago (IL)Google Scholar
  87. 87.
    Boger RH. Drug interactions of the statins and consequences for drug selection. Int J Clin Pharmacol Ther 2001; 39: 369–82PubMedGoogle Scholar
  88. 88.
    Lee AJ, Maddix DS. Rhabdomyolysis secondary to a drug interaction between simvastatin and clarithromycin. Ann Pharmacother 2001; 35: 26–31PubMedCrossRefGoogle Scholar
  89. 89.
    Bolt HM. Rifampicin, a keystone inducer of drug metabolism: from Herbert Remmer’s pioneering ideas to modern concepts. Drug Metab Rev 2004; 36: 497–509PubMedCrossRefGoogle Scholar
  90. 90.
    Shi J, Montay G, Leroy B, et al. Effects of itraconazole or grapefruit juice on the pharmacokinetics of telithromycin. Pharmacotherapy 2005; 25: 42–51PubMedCrossRefGoogle Scholar
  91. 91.
    Shi J, Chapel S, Montay G, et al. Effect of ketoconazole on the pharmacokinetics and safety of telithromycin and clarithromycin in older subjects with renal impairment. Int J Clin Pharmacol Ther 2005; 43: 123–33PubMedGoogle Scholar
  92. 92.
    Kane GC, Lipsky JJ. Drug-grapefruit juice interactions. Mayo Clin Proc 2000; 75: 933–42PubMedCrossRefGoogle Scholar
  93. 93.
    O’Reilly RA. Stereoselective interactions of trimethoprim-sulfamethoxazole with the separated enantiomorphs of racemic warfarin in man. N Engl J Med 1980; 302: 33–5PubMedCrossRefGoogle Scholar
  94. 94.
    Shrader SP, Fermo JD, Dzikowski AL. Azithromycin and warfarin interaction. Pharmacotherapy 2004; 24: 945–9PubMedCrossRefGoogle Scholar
  95. 95.
    Kolilekas L, Anagnostopoulos GK, Lampaditis I. Potential interaction between telithromycin and warfarin. Ann Pharmacother 2004; 38: 1424–7PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  • Steven D. Brown
    • 1
  1. 1.Clinical Microbiology InstituteWilsonvilleUSA

Personalised recommendations