Telithromycin (TEL) is a ketolide antibiotic with activity against the atypical pathogens Chlamydophila pneumoniae and Mycoplasma pneumoniae, which have been implicated as having a role in asthma. In the TELICAST study, the effects of a 10-day course of TEL on pulmonary function were studied in patients with an acute exacerbation of asthma. Adults with a previous diagnosis of asthma (duration >6 months) were enrolled within 24 hours of an acute asthma exacerbation requiring medical care and randomised (double-blind) to receive TEL 800 mg or placebo once daily for 10 days in addition to usual care. Mean improvements in pulmonary function tests (PFT) from baseline to end of treatment were:

Mean change
PFTTEL (n=126)Placebo (n=129)p-value
FEV1, L0.630.340.001
FEV1, % predicted, %
PEF, L/min115.888.90.036
PEF, % predicted, %21.817.00.028
FVC, L0.580.310.006
FEF25-75%, L/sec0.850.450.004

TEL-treated patients showed significantly greater improvements in lung function over those treated with placebo. This is the first study to provide evidence of significant and clinically important benefits of antibiotic treatment in acute exacerbations of asthma.