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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › MACROLIDES, LINCOSAMIDES AND STREPTOGRAMINS › Streptogramins
quinupristin/dalfopristin
J01FG02
Forms & Strengths
- Powder for injection: 500 mg vial (150 mg quinupristin / 350 mg dalfopristin)
Adult Dosing
- Complicated skin and skin structure infections: 7.5 mg/kg IV every 8 hours for at least 7 days
- Vancomycin-resistant Enterococcus faecium infections: 7.5 mg/kg IV every 8 hours for at least 14 days
Pediatric Dosing
- Safety and efficacy not established in pediatric patients (<16 years)
Indications
- Treatment of serious or life-threatening infections caused by Vancomycin-Resistant Enterococcus faecium (VREF)
- Complicated skin and skin structure infections caused by Staphylococcus aureus (methicillin-susceptible) or Streptococcus pyogenes
Mechanism of Action
- Streptogramin antibacterial combination acting synergistically
- Dalfopristin inhibits the early phase of protein synthesis by binding to the 50S ribosomal subunit
- Quinupristin inhibits the late phase of protein synthesis by binding to a different site on the 50S ribosomal subunit
- Bacteriostatic individually, but bactericidal in combination against most target organisms
Contraindications
- Known hypersensitivity to quinupristin, dalfopristin, or other streptogramins (e.g., pristinamycin)
Adverse Reactions
- Venous irritation, pain, and infusion site inflammation
- Arthralgia and myalgia syndrome (severe)
- Nausea, vomiting, and diarrhea
- Rash and pruritus
- Hyperbilirubinemia and elevated liver enzymes
Drug Interactions
- Potent inhibitor of CYP3A4, significantly increasing levels of co-administered drugs metabolized by this pathway
- Avoid concurrent use with medications that prolong the QT interval and are CYP3A4 substrates (e.g., dofetilide, quinidine)
- Increases levels of cyclosporine, tacrolimus, midazolam, and nifedipine via CYP3A4 inhibition
Curated Content: Needs Vetting Before Put to Clinical Use