Quinupristin and Dalfopristin

ByBrian J. Werth, PharmD, University of Washington School of Pharmacy
Reviewed/Revised May 2024
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Quinupristin and dalfopristin are streptogramin antibiotics, which, like macrolides and lincosamides, inhibit the synthesis of bacterial proteins.

D/Q inhibits Enterococcus faecium, including vancomycin-resistant strains. Enterococcus faecalis is resistant.

D/Q is given via a central IV catheter because phlebitis frequently occurs when D/Q is given via a peripheral vein. Up to 30% of patients develop significant myalgias. D/Q may cause hyperbilirubinemia.

Dosage reduction is required for severe hepatic insufficiency but not for renal insufficiency.

Safety Warning for Quinupristin and Dalfopristin

D/Q may inhibit the metabolism of medications that are metabolized by the cytochrome P-450 (CYP450) 3A4 isoenzyme system.

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