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Volume 355:96-98 July 6, 2006 Number 1
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Telithromycin in Acute Exacerbations of Asthma

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by Little, F. F.
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by Johnston, S. L.
-PubMed Citation
To the Editor: Johnston et al. (April 13 issue)1 report that the treatment of exacerbations of asthma with the ketolide telithromycin (a semisynthetic derivative of erythromycin) is associated with a clinical benefit; the underlying mechanism of effect remains unclear. In the absence of microbiologic explanations, the accompanying editorial by Little2 suggests a role for the immunomodulatory effects of macrolides. We would like to suggest another potential contributory mechanism — variations in drug metabolism. Telithromycin is a strong inhibitor of cytochrome P-450 isoenzyme 3A4 (CYP3A4).3 Two inhaled corticosteroids that are commonly used in clinical practice (budesonide and fluticasone) are metabolized to . . . [Full Text of this Article]



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