Quinupristin and Dalfopristin

Quinupristin and dalfopristin are streptogramin antibiotics, which, like macrolides and lincosamides, inhibit the synthesis of bacterial proteins.

Dalfopristin/quinupristin (D/Q) is given together in a fixed 70/30 combination; this combination has synergistic bactericidal activity against the following:Dalfopristin/quinupristin (D/Q) is given together in a fixed 70/30 combination; this combination has synergistic bactericidal activity against the following:

• Streptococci and staphylococci, including strains resistant to other antibiotic classes

• Some gram-negative anaerobic bacilli

• Clostridium perfringens

• Peptostreptococcus species

• Atypical respiratory pathogens (Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila)

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.