Quinupristin/dalfopristinquinupristin/dalfopristin, quinupristin/dalfopristin (synercid)
Quinupristin/dalfopristin pronunciation: kwi NYOO pris tin / dal FOE pris tin trade name Synercid is a combination of two antibiotics used to treat infections by staphylococci and by vancomycin-resistant Enterococcus faecium
Quinupristin and dalfopristin are both streptogramin antibiotics, derived from pristinamycin Quinupristin is derived from pristinamycin IA; dalfopristin from pristinamycin IIA They are combined in a weight-to-weight ratio of 30% quinupristin to 70% dalfopristin
- 1 Administration
- 2 Mechanism of action
- 3 Pharmacokinetics
- 4 Side effects
- 5 Drug interactions
- 6 References
- 7 Further reading
Intravenous, usually 75 mg/kg every 8–12 hours
Mechanism of action
Quinupristin and dalfopristin are protein synthesis inhibitors in a synergistic manner While each of the two is only a bacteriostatic agent, the combination shows bactericidal activity
- Dalfopristin binds to the 23S portion of the 50S ribosomal subunit, and changes the conformation of it, enhancing the binding of quinupristin by a factor of about 100 In addition, it inhibits peptidyl transfer
- Quinupristin binds to a nearby site on the 50S ribosomal subunit and prevents elongation of the polypeptide, as well as causing incomplete chains to be released
Clearance by the liver, half-life 1–3 hours with persistence of effects for 9–10 hours
- Joint aches arthralgia or muscle aches myalgia
- Nausea, diarrhea or vomiting
- Rash or itching
The drug inhibits P450 and enhances the effects of terfenadine, astemizole, indinavir, midazolam, calcium channel blockers, warfarin, cisapride and ciclosporin
- ^ a b c d Page 212 in: Title: Hugo and Russell's pharmaceutical microbiology Authors: William Barry Hugo, Stephen P Denyer, Norman A Hodges, Sean P Gorman Edition: 7, illustrated Publisher: Wiley-Blackwell, 2004 ISBN 0-632-06467-6, ISBN 978-0-632-06467-0 Length: 481 pages
- Allington DR, Rivey M Jan 2001 "Quinupristin/dalfopristin: a therapeutic review" Clin Ther 23 1: 24–44 doi:101016/S0149-29180180028-X PMID 11219478
- "Quinupristin/dalfopristin: a review of its use in the management of serious gram-positive infections" Drugs 58 6: 1061–97 December 1999 doi:102165/00003495-199958060-00008 PMID 10651391
- "Quinupristin-dalfopristin: a new antibiotic for severe gram-positive infections" Am Fam Physician 64 11: 1863–6 December 2001 PMID 11764864
- "MRSA" Med Clin North Am 85 1: 1–17 January 2001 doi:101016/s0025-71250570302-3 PMID 11190346
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