This story must be big news – it refers to a NEJM article. Antibiotic Eases Symptoms in Acute Asthma Attacks
The antibiotic Ketek (telithromycin) improved recovery from an acute asthma attack by three days, reduced symptoms, and improved hospital-based lung function measurements, researchers here reported.
Ketek is a ketolide, a new class of antibiotics structurally related to the macrolides. It has a bactericidal effect against the atypical pathogens Chlamydophila pneumoniae and Mycoplasma pneumoniae, and for that reason the researchers decided to study its potential role in acute asthma attacks, according to a report in the April 13 New England Journal of Medicine.
Ketek does not have FDA approval for asthma, but it was approved in April 2004 for community-acquired pneumonia, acute exacerbations of chronic bronchitis, and acute bacterial sinusitis in adults.
In the investigation, known as the TELICAST (Telithromycin, Chlamydophila, and Asthma) trial, 278 adults were enrolled within 24 hours of an acute exacerbation of asthma requiring short-term medical care. The patients were randomly assigned to 10 days of oral treatment with Ketek (800 mg daily) or placebo, in addition to usual care, reported Sebastian Johnston, M.D., Ph.D., of Imperial College London, and a multinational team of colleagues.
The two primary outcomes were split, Dr Johnston said. Asthma symptoms were significantly reduced among patients receiving Ketek compared with those given a placebo, whereas antibiotic therapy had no significant effect on the patients’ morning measures of peak expiratory flow.
These data are interesting. One can construct a plausible theory for this result. However, as I often do, I must urge caution. We certainly need more than one study to change practice. This antibiotic may have some serious rare side effects.
As for safety, a recent report highlighted three cases of severe liver injury among patients treated with Ketek, the researchers noted, adding that their study was too small to give reliable information about these rare adverse events.
So I file this study under the heading interesting, awaits confirmation.
