Telithromycin is a macrolide antibiotic with a negative risk-benefit balance. Its efficacy is no better than that of other macrolides. Telithromycin carries a risk of serious adverse effects, including loss of consciousness, QT prolongation, severe liver damage, aggravation of myasthenia gravis, and a high risk of drug interactions. In Finland, a 7-year pharmacovigilance review identified 20 reports of visual disorders among patients taking telithromycin, including blurred vision, accommodation disorder and diplopia, mainly in young patients and women. Visual disorders occurred in about 1% of patients receiving telithromycin in clinical trials. They were generally moderate, brief and reversible. These visual disorders may result from reversible paralysis of the ciliary body due to telithromycin. In practice, these visual disorders, which can be dangerous when driving or operating heavy machinery, add to the already long list of adverse effects of telithromycin.They are yet another reason not to use telithromycin, but rather a safer macrolide such spiramycin.
