Infectious Disease Compendium

Telithromycin (Ketek®)

Dosing

CrCl Formula

CrCl > 80: 800 mg po qd.

Important side effects

Nausea, vomiting, diarrhea, headache, dizziness, blurred vision, diplopia, difficulty focusing, severe visual disturbances. INCREASED INCIDENCE OF HEPATIC TOXICITY AND DEATH LIMITS ITS USE TO PNEUMONIA AND EVEN THEN WHY NOT USE SOMETHING SAFER? And no, my caps lock key was not inadvertantly on.

Important drug interactions

Antipsychotics, arsenic trioxide, astemizole, atorvastatin, bepridil, carbamazepine, chloral hydrate, chloroquine, cisapride, clarithromycin, class i antiarrhythmic agents, class ia antiarrhythmic agents, class III antiarrhythmic agents, cyclosporine, digoxin, dihydroergotamine, dolasetron, droperidol, enflurane, ergoloid mesylates, ergotamine, erlotinib, erythromycin, fluconazole, fluoxetine, foscarnet, fosphenytoin, halofantrine, halothane, hexobarbital, isoflurane, isradipine, levomethadyl, lidoflazine, lovastatin, mefloquine, mesoridazine, methylergonovine, metoprolol, octreotide, ondansetron, pentamidine, phenobarbital, phenothiazines, phenytoin, pimozide, probucol, rifampin, simvastatin, sirolimus, spiramycin, sulfamethoxazole, tacrolimus, terfenadine, theophylline, thioridazine, tricyclic antidepressants, trimethoprim, vasopressin, venlafaxine, verapamil, warfarin.

Rants and Screeds

Warning. Warning. Fatal hepatic necrosis reported (PubMed).

Pearls

Treatment of choice see side effects above.

Use for

Approved in package insert for acute exacerbation of chronic Bronchitis due to Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis. Acute bacterial Sinusitis from Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus.

Mild to moderate community acquired pneumonia from Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Chlamydia pneumoniae, or Mycoplasma pneumoniae.

Don't use for

Class

Macrolide.