Eligibility Criteria:
Inclusion Criteria:
General Conditions
* Outpatients
* Fulfillment of clinical diagnostic criteria for one of the following indications:
* Mild to moderate Community Acquired Pneumonia (CAP)
* Acute bacterial Exacerbation of Chronic Bronchitis (AECB)
* Acute Sinusitis (AS)
For CAP
The Criteria to be fulfilled are:
* New onset of at least two of the following:
* Cough
* Production of purulent sputum
* Auscultatory findings compatible with pneumonia, e.g. rales, evidence of pulmonary consolidation
* Dyspnea or tachypnea
* Fever
* Elevated total white blood cell count \> 10 000/mm3 or \>15% bands regardless of total count
* Chest X-ray findings supporting a clinical diagnosis of bacterial pneumonia (e.g. new infiltrate)
For AECB
The Criteria to be fulfilled are:
* Chronic bronchitis defined as cough and excessive sputum production for more than 2 consecutive years and on most days in a 3-month consecutive period.
* Exacerbation defined by:
* Increase in sputum purulence, or
* Increase in sputum volume, or
* Increase in dyspnea
For AS
The criteria to be fulfilled are:
At least two of the major or one major and two minor factors listed below, for more than one week and less than 4 weeks:
* Major factors:
* Facial pressure and/or pain
* Facial congestion or fullness
* Nasal obstruction
* Nasal purulence or postnasal discharge
* Hyposmia or anosmia
* Fever
* Minor factors:
* Headache
* Halitosis
* Fatigue
* Dental pain
* Cough
* Ear pain, pressure or fullness
Exclusion Criteria:
General Conditions
Subjects presenting with any of the following will not be included in the study:
* Treatment required during the study with ergot alkaloid derivatives, pimozide, astemizole, terfenadine, cisapride, simvastatin, atorvastatin and lovastatin, and the oral use of the benzodiazepines midazolam, triazolam and alprazolam.
* History of congenital or family history of long QT syndrome (if not excluded by ECG) or known acquired QT interval prolongation.
* Known hypersensitivity to telithromycin or to macrolide antibiotics.
* Hospital acquired infections (hospitalization for more than 72 hours within 7 days of study entry).
* Pregnant or breast-feeding women. For the women of childbearing potential it is left to the investigators discretion to establish a lack of pregnancy, e.g. with contraceptive use, menstrual pattern, urinary pregnancy test.
* Subjects with severely impaired renal function (creatinine clearance \<30 ml/min).
* Subjects that had received anti-bacterials for more than 24 hours within 7 days prior to enrollment in the study, unless the treatment has failed.
* Subjects receiving medications, including other anti-microbials or anti-cancer drugs, that could interfere with the evaluation.
* Microbiologically documented infection with a pathogen known prior to inclusion to be resistant to the study medications.
* Infection, other than the primary infection for which the subject is being included in the study that requires use of other systemic anti-bacterial drug.
* Splenectomised subjects.
* Use of KetekĀ® (telithromycin) or participation in a study using KetekĀ® (telithromycin) in the previous 30 calendar days.
* Subjects that have received any investigational drug within 4 weeks of enrollment in the study.
* No subject will be allowed to enroll in this study more than once.
For CAP
Additional exclusion criteria are:
* Severe pneumonia defined by any one of the following:
* Judged as needing Intensive Care Unit admission.
* Need of parenteral antibiotic treatment (if the attending physician wants to prescribe a parenteral treatment for adherence reasons or local prescription habits this is accepted, provided that the patient does not have a severe pneumonia).
* Acute respiratory failure or requirement for mechanical ventilation.
* Altered mental status resulting from the infective process.
* Resting respiratory rate \> 30 breaths/min.
* Chest X-ray showing increase in opacity by \> 50% within 48 hours of current evaluation.
* Total white blood cell count \< 4 000/mm3.
* Aspiration pneumonia.
* Pneumonia suspected to be non-bacterial (due to fungus or viral).
* Subjects suffering from severe bronchiectasis (production of more than 125 mL of sputum/day), cystic fibrosis, active tuberculosis, pulmonary infarction or embolism, bronchial obstruction, lung cancer or lung metastasis, lung abscess, extra-pulmonary extension (like meningitis, septic arthritis, endocarditis).
For AECB
Additional exclusion criteria are:
* Need of parenteral antibiotic treatment (if the attending physician wants to prescribe a parenteral treatment for adherence reasons or local prescription habits this is accepted, provided that the patient does not have a severe infection).
* Acute respiratory failure (respiratory distress, hypercarbia, worsening hypoxemia) or requirement for mechanical ventilation.
* Severe bronchiectasis, cystic fibrosis, active tuberculosis, pulmonary infarction or embolism, bronchial obstruction, lung cancer or lung metastasis, lung abscess.
For AS
Additional exclusion criteria are:
* Need of immediate surgery for the treatment of AS.
* Chronic sinusitis (symptoms lasting more than 4 weeks).
* Recurrent sinusitis (4 or more episodes of sinusitis requiring antibiotic therapy in the previous 12 months).
* Nosocomial acquired sinusitis.
* Cystic fibrosis, immotile cilia syndrome.
* Obstructive lesions in nasopharynx (e.g. polyps, tumor).
* Use of nasal, nasogastric or nasotracheal catheters.