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Cethromycin; Uses, Dosage, Side Effects, Drug Interactions

Cethromycin is a ketolide antibiotic undergoing research for the treatment of community acquired pneumonia (CAP) and for the prevention of post-exposure inhalational anthrax, and was given an “orphan drug” status for this indication. Originally discovered and developed by Abbott, it was acquired by Advanced Life Sciences Inc. for further development. In June 2009,an FDA Anti-Infective Drugs Advisory Committee review found insufficient evidence for cethromycin efficacy in treatment of community acquired pneumonia, as the Phase 3 clinical trial followed standards that were updated after the clinical trial but three months prior to review. The committee did, however, find the drug safe to use.

Cethromycin is a ketolide antibiotic undergoing research for the treatment of community-acquired pneumonia (CAP)and for the prevention of post-exposure inhalational anthrax and was given an “orphan drug” status for this indication. Originally discovered and developed by Abbott, it was acquired by Advanced Life Sciences Inc. for further development. On October 1, 2008, Advanced Life Sciences submitted a New Drug Application (NDA) to Food and Drug Administration (FDA) for cethromycin to treat mild-to-moderate community acquired pneumonia.

Mechanism of Action of Cethromycin

Cethromycin is a ketolide antibiotic derived from erythromycin A with a 14 membered macrolide group. Its greater potency than macrolide antibiotics such as erythromycin, clrithromycin, and azithromycin may be duce to increased ribosomal binding affinity, increasing accumulation and decreasing efflux. Ketolide antibiotics lack the 3-O-cladinose (replaced by a keto group), an 11,12- or 6,11-cyclic moiety and a heteroaryl-alkyl side chain attached to the macrocyclic ring contained in macrolide antibiotics. They bind at two distinct binding sites in the 23S rRNA.

Indications of Cethromycin

Community acquired pneumonia
post-exposure inhalational anthrax
Treatment in bacterial infection, pediatric indications, and pneumonia.
Bronchitis
Bacterial Endocarditis Prevention
Follicular Lymphoma
Helicobacter Pylori Infection
Legionella Pneumonia
Mycobacterium avium intracellulare,
Mycoplasma Pneumonia
Nongonococcal Urethritis

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Contraindications of Cethromycin

Contraindications: hypersensitivity to cethromycin, telithromycin or macrolides.

Precautions: cethromycin might potentially prolong the QT interval; avoid with drugs known to be associated with cardiac toxicities

Dosage of Cethromycin

No data available about this product

Side Effects of Cethromycin

The most common

Gastrointestinal: nausea, vomiting, diarrhea
Cardiovascular System: atrial arrhythmias, flushing, hypotension, bradycardia
Central Nervous System: a headache, dizziness, somnolence, insomnia, vertigo
Endocrine: increased sweating
Hepatic: reversal hepatitis, abnormal LFTs
Ocular: blurred vision, diplopia
Respiratory: respiratory failure in myasthenia gravis patients
Musculoskeletal: worsening of myasthenia gravis symptoms
Hematologic: thrombocytosis
Dermatologic: skin rashes

Drug Interactions of Cethromycin

Note: Although clinical trials are not available for cethromycin, it is expected that the drug acts similarly to other ketolides with respect to toxicity and drug interactions:

Interactions of major severity include drugs that have additive effects on QT prolongation. These drugs are contraindicated in patients taking telithromycin and not recommended in patients taking cethromycin. Examples include: antipsychotics, arsenic trioxide,.astemizole, bepedril, chloral hydrate, chloroquine, cisapride, clarithromycin, antiarrhythmic agents, cotrimoxazole, dolesetron, droperidol, enflurane, erythromycin, fluconazole, fluoxetine, foscarnet, halfantrine, halothane, isradipine, isoflurane, phenothiazines, and pimozide, along with many others.

Interactions of major severity include drugs that are substrates of CYP-3A4. Telithromycin (and possibly cethromycin) inhibits this enzyme, resulting in increased serum levels of the following drugs and others metabolized by CYP-3A4: atorvastatin, dihydroergotamine, ergot derivatives.

Pregnancy & Lactation of Cethromycin

Pregnancy

Cethromycin is in phase III trials. No data available for pregnant women or lactating mothers. So use this product with out consulting your doctors or pharmacist.

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