View source for Quinupristin/dalfopristin

==Uses==
*[[Antibiotic]]: 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==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*[[Lactation risk categories|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==
===Serious===

===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: 

==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||X1
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||'''S'''
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||'''S'''
|-
| ||[[CA-MRSA]]||'''S'''
|-
| ||[[Staph. Epidermidis]]||'''S'''
|-
| ||[[C. jeikeium]]||'''S'''
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||X2
|-
| ||[[N. meningitidis]]||R
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||I
|-
| ||[[E. coli]]||R
|-
| ||[[Klebsiella]] sp||R
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||X1
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||R
|-
| ||[[Shigella]] sp||R
|-
| ||[[Proteus mirabilis]]||X1
|-
| ||[[Proteus vulgaris]]||X1
|-
| ||[[Providencia sp.]]||X1
|-
| ||[[Morganella sp.]]||X1
|-
| ||[[Citrobacter freundii]]||X1
|-
| ||[[Citrobacter diversus]]||X1
|-
| ||[[Citrobacter sp.]]||X1
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||X1
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||X1
|-
| ||[[Stenotrophomonas maltophilia]]||X1
|-
| ||[[Yersinia enterocolitica]]||X1
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||X1
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X2
|-
| ||[[Mycoplasm pneumoniae]]||'''S'''
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||R
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||X1
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||I
|-
| ||[[Clostridium (not difficile)]]||X2
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||X1
|}

===Key===
{{Template:Antibacterial Spectra Key}}

==See Also==
*[[Antibiotics]]
*[[MRSA]]
*[[Vancomycin]]

==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
[[Category:Pharmacology]]
[[Category:ID]]