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Quinupristin-dalfopristin: an overview
G Delgado1, M M Neuhauser, D T Bearden
1Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 60612, USA.
Pharmacotherapy
|December 29, 2000
Summary
Synercid (quinupristin-dalfopristin) is a novel antibiotic effective against resistant gram-positive pathogens. It exhibits synergistic bactericidal activity, offering a treatment option for severe infections.
Area of Science:
- Pharmacology
- Microbiology
- Infectious Diseases
Background:
- Synercid (quinupristin-dalfopristin) is the first injectable streptogramin antibiotic.
- It comprises two semisynthetic pristinamycin derivatives: quinupristin and dalfopristin.
Purpose of the Study:
- To evaluate the efficacy and pharmacokinetic profile of Synercid.
- To determine its role in treating infections caused by multiresistant gram-positive pathogens.
Main Methods:
- Pharmacokinetic analysis of quinupristin-dalfopristin.
- Assessment of in vitro activity against various bacterial strains.
- Review of adverse events and drug interactions.
Main Results:
- Synergistic bactericidal activity against staphylococci and streptococci.
- Bacteriostatic activity against Enterococcus faecium; poor activity against Enterococcus faecalis.
- Extended postantibiotic effect allowing 8-12 hour dosing despite short half-life.
- Hepatic metabolism and biliary excretion; inhibition of CYP3A4 substrates.
- Adverse events include arthralgia, myalgias, and infusion pain.
Conclusions:
- Synercid demonstrates a valuable role in treating severe infections caused by multiresistant gram-positive pathogens.
- Dosage adjustments may be needed in hepatic dysfunction; renal function has minimal impact.
- Potential for drug interactions due to CYP3A4 inhibition requires consideration.