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Vol. 22. Núm. 6.
Páginas 323-327 (junio 2004)
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Vol. 22. Núm. 6.
Páginas 323-327 (junio 2004)
Acceso a texto completo
Actividad de telitromicina y otros antimicrobianos de administración oral frente a patógenos del aparato respiratorio con mecanismos de resistencia adquiridos
Activity of telithromycin and other oral antibiotics against respiratory tract pathogens with acquired mechanisms of resistance
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5154
José Luis Gómez-Garcés1
Autor para correspondencia
jlgarces@microb.net

Correspondencia: Dr. J.L. Gómez-Garcés. Servicio de Microbiología. Hospital de Móstoles. Río Júcar, s/n. Móstoles. 28935 Madrid. España.
, Juan Ignacio Alós, Carmen Hernáiz, Carmen Gómez
Servicio de Microbiología. Hospital de Móstoles. Instituto Madrileño de la Salud. Móstoles. Madrid. España
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Bibliografía
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Estadísticas
Introducción

La adquisición de mecanismos de resistencia a diferentes antibióticos en cepas de Streptococcus pneumoniae, Haemophilus influenzae y Streptococcus pyogenes ha limitado la utilidad de antimicrobianos clásicos utilizados en el tratamiento de algunas enfermedades infecciosas relacionadas con estos microorganismos, siendo necesaria la aportación de nuevas moléculas activas frente a estas cepas resistentes.

Objetivos

Conocer la sensibilidad de 307 cepas de S. pneumoniae, H. influenzae y S. pyogenes que presentan mecanismos de resistencia adquiridos a macrólidos y/o betalactámicos frente a telitromicina y otros antimicrobianos de uso preferentemente oral.

Métodos

El estudio de la sensibilidad se llevó a cabo mediante dilución en agar y los resultados se valoraron utilizando preferentemente criterios establecidos por el National Committee for Clinical Laboratory Standards (NCCLS).

Resultados

El comportamiento de telitromicina frente a S. pneumoniae resistentes a eritromicina fue excelente, no encontrándose ninguna cepa que no se inhibiera con 2 mg/l, independientemente del mecanismo de resistencia a macrólidos exhibido.

Frente a H. influenzae productores de betalactamasa, la telitromicina fue ligeramente más activa que los macrólidos probados, con una concentración inhibitoria mínima al 90% (Cim90) de 2 mg/l.

La telitromicina fue igualmente un agente muy activo frente a S. pyogenes resistentes a macrólidos y tan sólo una cepa de las 202 probadas precisó más de 4 mg/l para su inhibición.

Conclusiones

La telitromicina resulta un agente muy prometedor entre las opciones terapéuticas existentes frente a los patógenos bacterianos del aparato respiratorio, incluyendo aquellos que han desarrollado mecanismos de resistencia a macrólidos y/o betalactámicos.

Palabras clave:
Streptococcus pneumoniae
Haemophilus influenzae
Streptococcus pyogenes
Resistencia a antimicrobianos
Telitromicina
Introduction

Antimicrobial resistance among strains of Streptococcus pneumoniae, Haemophilus influenza, and Streptococcus pyogenes has limited the usefulness of conventional agents for the treatment of some infectious diseases related with these microorganisms. There is thus a clear need for new antimicrobial agents active against these resistant strains.

Objectives

To assess the in vitro susceptibility to telithromycin and other oral antimicrobial agents of 307 strains of S. pneumoniae, H. influenzae, and S. pyogenes with acquired mechanisms of resistance to macrolides and/or beta-lactams.

Methods

Antimicrobial susceptibility testing was performed by the agar dilution method, and results were preferentially evaluated according to National Committee for Clinical Laboratory Standards (NCCLS) guidelines.

Results

The activity of telithromycin against erythromycin-resistant S. pneumoniae was excellent. All the strains were inhibited with 2 mg/l, regardless of the mechanism of macrolide resistance exhibited.

Telithromycin was slightly more active than the tested macrolides in beta-lactamase-producing H. influenzae strains, with a MIC90 of 2 mg/l. Telithromycin also demonstrated potent activity against macrolide-resistant S. pyogenes. The MIC of telithromycin was > 4 mg/l for only one out of the 202 tested strains.

Conclusions

Telithromycin is a very promising therapeutic option against bacterial pathogens of the respiratory tract, including strains that have developed mechanisms of resistance to macrolides and/or beta-lactams.

Key words:
Streptococcus pneumoniae
Haemophilus influenzae
Streptococcus pyogenes
Antimicrobial susceptibility
Telithromycin
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Copyright © 2004. Elsevier España, S.L.. Todos los derechos reservados
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