Quinupristin/dalfopristin

Uses

• Treatment of vancomycin-resistant Enterococcus faecium, as well as nosocomial pneumonias and infections secondary to IV catheters (1)

Administration

• Dosage Forms: 500mg vials, diluted into 250 mL and given over 60 mins
• Routes of Administration: IV
• Common Trade Names: Synercid

Adult Dosing

• VRE: 7.5mg/kg IV q8 hrs for minimum 7 days
• skin infections: 7.5mg/kg IV q12 hrs for minimum 7 days

Pediatric Dosing

• safety and efficacy has not been studied in children

Special Populations

• Pregnancy Rating: B
• Lactation risk: unknown whether secreted in human breast milk. Caution should be exercised when administering to nursing mothers. (2)

Renal Dosing

• no adjustments for renal impairment

Hepatic Dosing

• dosage may need to be adjusted in patients with cirrhosis, however specific dose modification is not known at this time (2)

Contraindications

• Allergy to class/drug

Adverse Reactions

Common

• pain and inflammation at infusion site
• arthralgias
• nausea/vomiting/diarrhea
• rash
• headache
• pruritus

Pharmacology

• Half-life: Quinupristin: 3 hrs; Dalfopristin: 1 hr
• Metabolism: significantly interacts with the CYP 3A4 system.
• Excretion:

References

• 1. JP Manzanella. "Quinupristin-Dalfopristin: A New Antibiotic for Severe Gram-Positive Infections." American Family Physician. 2001 Dec 1;64(11):1863-1867.
• 2. U.S. Food and Drug Administration. Synercid I.V. November 2007. Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/050748s008,050747s008lbl.pdf

Authors

Nicole Zadzilka, Neil Young, Daniel Ostermayer