Infectious Disease Book

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Quinupristin-DalfopristinAka: Synercid, Streptogramin

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  1. Indications: Severe Gram Positive Infections
    1. Vancomycin-resistant Enterococcus
    2. Methicillin susceptible Staphylococcus aureus
    3. Methicillin susceptible Streptococcus Pyogenes
  2. Mechanism
    1. Bacterial 50S Ribosome
    2. Resistance rare
  3. Pharmacokinetics
    1. Hepatic clearance predominates
    2. Half-life: 1-3 hours (9-10 hours of affect)
  4. Adverse Effects
    1. Arthralgias or myalgias
    2. Nausea, Diarrhea or Vomiting
    3. Rash or Pruritus
    4. Headache
  5. Drug Interactions: Metabolized by Cytochrome P-450 3A4
    1. Raises serum drug levels of substrates in 3A4 system
    2. Follow cyclosporine levels when using concurrently
  6. Dosing
    1. Enterococcus faecium: 7.5 mg/kg IV q8 hours
    2. Severe Skin Infections: 7.5 mg/kg IV q12 hours
  7. References
    1. Allington (2001) Clin Ther 23(1):24
    2. Lamb (1999) Drugs 58(6):1061
    3. Lundstrom (2000) Infect Dis Clin North Am 14(2):463
    4. Manzella (2001) Am Fam Physician 64(11):1863
    5. Paradisi (2001) Med Clin North Am 85(1):1

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