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Quinupristin/dalfopristin , or 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.
Administration [ edit ]
Intravenous , usually 7.5 mg/kg every 8 hours (infections/life threatening VRSA); every 12 hours (skin infections).
No renal dosing adjustments, hepatic dosing adjustments are not defined, consider reducing dose.
Mechanism of action [ edit ]
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[1] peptidyl transfer .[1]
Quinupristin binds to a nearby site on the 50S ribosomal subunit and prevents elongation of the polypeptide ,[1] [1]
Pharmacokinetics [ edit ]
Clearance by the liver CYP450:3A4 inhibitor, half-life quinupristin 0.8 hours, dalfopristin 0.7 hours (with persistence of effects for 9–10 hours).
Side effects [ edit ]
[2]
Serious:
C.diff-associated diarrhea
superinfection
anaphylactoid reactions
angioedema
Common:
Joint aches (arthralgia) or muscle aches (myalgia)
Nausea , diarrhea (C. diff associated) or vomiting
Rash or itching
Headache
Hyperbilirubinemia
Anemia
Thrombophlebitis
Drug interactions [ edit ]
The drug inhibits P450 and enhances the effects of terfenadine , astemizole , indinavir , midazolam , calcium channel blockers , warfarin , cisapride and ciclosporin .
References [ edit ]
Further reading [ edit ]
Lamb HM, Figgitt DP, Faulds D (December 1999). "Quinupristin/dalfopristin: a review of its use in the management of serious gram-positive infections". Drugs . 58 6 ): 1061–97. doi :10.2165/00003495-199958060-00008 . PMID 10651391 . S2CID 209144323 .
Manzella JP (December 2001). "Quinupristin-dalfopristin: a new antibiotic for severe gram-positive infections". American Family Physician . 64 11 ): 1863–6. PMID 11764864 .
Paradisi F, Corti G, Messeri D (January 2001). "Antistaphylococcal (MSSA, MRSA, MSSE, MRSE) antibiotics" (PDF) . The Medical Clinics of North America . 85 1 ): 1–17. doi :10.1016/s0025-7125(05 )70302-3 . hdl :2158/329747 PMID 11190346 .
"Synercid" . U.S. Food and Drug Administration. Archived from the original on 2007-06-18.
R e t r i e v e d f r o m " https://en.wikipedia.org/w/index.php?title=Quinupristin/dalfopristin&oldid=1197167855 " C a t e g o r y : ● C o m b i n a t i o n a n t i b i o t i c s H i d d e n c a t e g o r i e s : ● A r t i c l e s w i t h s h o r t d e s c r i p t i o n ● S h o r t d e s c r i p t i o n m a t c h e s W i k i d a t a ● A r t i c l e s w i t h c h a n g e d C A S N o i d e n t i f i e r ● A r t i c l e s w i t h o u t E B I s o u r c e ● C h e m i c a l p a g e s w i t h o u t D r u g B a n k i d e n t i f i e r ● A r t i c l e s w i t h o u t K E G G s o u r c e ● A r t i c l e s w i t h o u t I n C h I s o u r c e ● A r t i c l e s w i t h o u t U N I I s o u r c e ● D r u g b o x e s w h i c h c o n t a i n c h a n g e s t o v e r i f i e d f i e l d s ● D r u g s t h a t a r e a c o m b i n a t i o n o f c h e m i c a l s
● T h i s p a g e w a s l a s t e d i t e d o n 1 9 J a n u a r y 2 0 2 4 , a t 1 3 : 0 4 ( U T C ) . ● T e x t i s a v a i l a b l e u n d e r t h e C r e a t i v e C o m m o n s A t t r i b u t i o n - S h a r e A l i k e L i c e n s e 4 . 0 ;
a d d i t i o n a l t e r m s m a y a p p l y . B y u s i n g t h i s s i t e , y o u a g r e e t o t h e T e r m s o f U s e a n d P r i v a c y P o l i c y . W i k i p e d i a ® i s a r e g i s t e r e d t r a d e m a r k o f t h e W i k i m e d i a F o u n d a t i o n , I n c . , a n o n - p r o f i t o r g a n i z a t i o n . ● P r i v a c y p o l i c y ● A b o u t W i k i p e d i a ● D i s c l a i m e r s ● C o n t a c t W i k i p e d i a ● C o d e o f C o n d u c t ● D e v e l o p e r s ● S t a t i s t i c s ● C o o k i e s t a t e m e n t ● M o b i l e v i e w
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