Telithromycin versus clarithromycin for the treatment of community-acquired respiratory tract infections: a meta-analysis of randomized controlled trials / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 2179-2185, 2013.
Article
in English
| WPRIM
| ID: wpr-273015
ABSTRACT
<p><b>BACKGROUND</b>The emergence of bacterial resistance to commonly used antibiotics, such as macrolides, is complicating the management of respiratory tract infections (RTIs). Telithromycin, a ketolide antimicrobial structurally related to macrolides, is approved for the treatment of community-acquired RTIs, and shows lower pathogen resistance rates. The purpose of this study was to compare the efficacy and safety of telithromycin with clarithromycin, a macrolide routinely used as therapy for RTIs.</p><p><b>METHODS</b>We performed a meta-analysis of relevant randomized-controlled trials (RCTs) identified in PubMed, the Cochrane Library, Embase, CNKI and VIP databases. The primary efficacy outcome was clinical treatment success assessed at the test-of-cure time in the per-protocol population, and the primary safety outcome was drug related adverse effects.</p><p><b>RESULTS</b>Seven RCTs, involving 2845 patients with RTIs, were included in the meta-analysis. Oral telithromycin and clarithromycin showed a similar clinical treatment success in modified intention to treat and per-protocol population (cure and improvement) (odds ratios (ORs) 0.84, 95% confidence intervals (CI) 0.64 - 1.11 and OR 1.14, 95%CI 0.71 - 1.85, respectively). Similar findings were obtained for secondary efficacy outcomes:
clinical treatment success at a late post-therapy visit (OR 0.92, 95%CI 0.57 - 1.48) and microbiological treatment success at the test-of-cure time (OR 1.14; 95%CI 0.71 - 1.85). The safety outcome analysis indicated telithromycin had a similar risk of drug-related adverse effect and serious adverse effect with clarithromycin.</p><p><b>CONCLUSIONS</b>Our findings indicate that oral telithromycin and clarithromycin have similar treatment efficacy and adverse effect. The advantages of lower antimicrobial resistance rates, once-daily short-duration dosing and reported lower health-care costs make oral telithromycin a useful option for the empiric management of mild-to-moderate RTIs.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Respiratory Tract Infections
/
Randomized Controlled Trials as Topic
/
Clarithromycin
/
Community-Acquired Infections
/
Therapeutic Uses
/
Ketolides
/
Drug Therapy
/
Anti-Bacterial Agents
Type of study:
Controlled clinical trial
/
Practice guideline
/
Prognostic study
/
Systematic reviews
Limits:
Humans
Language:
English
Journal:
Chinese Medical Journal
Year:
2013
Type:
Article
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