IDStewardship

  • Home
  • Articles
  • LEARN ANTIBIOTICS
  • Study Guide
  • Resources
  • Q&A
  • #ASPchat
  • Contributors
  • About

Quinupristin-dalfopristin (Synercid)

[Quinupristin-dalfopristin photo]

KEY POINTS

  • Quinupristin-dalfopristin (Synercid) is a streptogramin antimicrobial agent that interferes with bacterial protein synthesis in susceptible isolates through interaction with the 50S bacterial ribosomal subunit
    • Dalfopristin inhibits the early phase of protein synthesis
    • Quinupristin inhibits the late phase of protein synthesis
    • Exhibits bacteriostatic killing
  • Is rarely used in clinical practice due to substantial toxicities and alternative therapies for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE)
    • When it is used, the indication is typically for a complicated case involving infection due to vancomycin-resistant Enterococcus faecium
  • Has activity versus numerous drug-resistant Gram positive bacteria
    • Has activity versus Enterococcus faecium, including some vancomycin-resistant isolates (i.e., VRE)
    • Nearly all Enterococcus faecalis isolates are resistant to quinupristin-dalfopristin
    • Has activity against some MRSA isolates
  • Common dose in adults is 7.5 mg/kg every 8-12 hours
    • No adjustment for renal function
      • Mostly excreted in feces
    • Adjustments may be needed for hepatic function
  • Some serious toxicities of concern that occurs at a disturbingly high rate include: arthralgia and myalgias, phlebitis, and hyperbilirubinemia
  • Administration of quinupristin-dalfopristin can be complicated
    • Typical infusion time is 1 hour and volume of 250mL D5W
    • May require larger fluid volume to reduce phlebitis
    • Is preferable to infuse via a central line to limit venous irritation
    • Can precipitate if mixed with normal saline or heparin, so need to flush the line with D5W before and after doses
    • See package insert for more details on this issue
  • Not widely available (if at all) on the US market

RESOURCES

  • Quinipristin-dalfopristin Package Insert
  • Role of Combination Antimicrobial Therapy for Vancomycin-Resistant Enterococcus faecium Infections: Review of the Current Evidence [Pharmacotherapy, 2017]
  • Quinupristin–dalfopristin and linezolid: evidence and opinion [Clinical Infectious Diseases, 2003]
  • Quinupristin/dalfopristin: a therapeutic review. [Clinical Therapeutics, 2001]

Free Antibiotic Cheat Sheet

Study Guide

  • Pharmacotherapy Study Guide
  • Acyclovir (Zovirax)
  • Albendazole (Albenza)
  • Amikacin
  • Aminoglycosides
  • Amphotericin B (Fungizone, Abelcet, Ambisome)
  • Amoxicillin (Amoxil)
  • Amoxicillin-Clavulanic Acid (Augmentin)
  • Ampicillin
  • Ampicillin-sulbactam (Unasyn)
  • Anidulafungin (Eraxis)
  • Artesunate
  • Atovaquone (Mepron)
  • Azithromycin (Zithromax, Zmax)
  • Aztreonam (Azactam, Cayston)
  • Aztreonam-avibactam (Emblaveo)
  • Bacitracin
  • Baloxavir marboxyl (Xofluza)
  • Bamlanivimab
  • Baricitinib (Olumiant)
  • Bebtelovimab
  • Bezlotoxumab (Zinplava)
  • Brincidofovir (Tembexa)
  • Cantharidin (Ycanth)
  • Casirivimab and Imdevimab (REGEN-COV)
  • Caspofungin (Cancidas)
  • Cefazolin (Ancef)
  • Cefepime (Maxipime)
  • Cefepime-enmetazobactam (Exblifep)
  • Cefepime-Taniborbactam
  • Cefiderocol (Fetroja)
  • Ceftaroline (Teflaro)
  • Ceftazidime (Fortaz, Tazicef)
  • Ceftazidime-avibactam (Avycaz)
  • Ceftobiprole medocaril (Zevtera)
  • Ceftolozane-Tazobactam (Zerbaxa)
  • Ceftriaxone (Rocephin)
  • Cefoxitin (Mefoxin)
  • Cephalexin (Keflex)
  • Cidofovir (Vistide)
  • Ciprofloxacin (Cipro)
  • Clarithromycin (Biaxin)
  • Clindamycin (Cleocin)
  • Colistin (colistimethate)
  • Cycloserine (Seromycin)
  • Dalbavancin (Dalvance)
  • Daptomycin (Cubicin)
  • Delafloxacin (Baxdela)
  • Dicloxacillin
  • Doripenem (Doribax)
  • Doxycycline (Doryx)
  • Elbasvir/ grazoprevir (Zepatier)
  • Eravacycline (Xerava)
  • Ertapenem (Invanz)
  • Erythromycin
  • Famciclovir (Famvir)
  • Fecal Microbiota Spores, Live-brpk (Vowst, SER-109)
  • Fidaxomicin (Dificid)
  • Fluconazole (Diflucan)
  • Flucytosine (Ancobon)
  • Foscarnet (Foscavir)
  • Fosfomycin (Monurol)
  • Ganciclovir (Cytovene)
  • Gentamicin (Garamycin)
  • Gepotidacin (Blujepa)
  • Glecaprevir/ Pibrentasvir (Mavyret)
  • Ibrexafungerp (Brexafemme)
  • Imipenem-cilastatin (Primaxin)
  • Imipenem-cilastatin-relebactam (Recarbrio)
  • Isavuconazole (Cresemba)
  • Itraconazole (Sporanox)
  • Ivermectin (Stromectol)
  • Ledipasvir/sofosbuvir (Harvoni)
  • Lefamulin (Xenleta)
  • Letermovir (Prevymis)
  • Levofloxacin (Levaquin)
  • Linezolid (Zyvox)
  • Maribavir (Livtencity)
  • Meropenem (Merrem)
  • Meropenem-vaborbactam (Vabomere)
  • Metronidazole (Flagyl)
  • Methenamine (Hiprex, Urex)
  • Micafungin (Mycamine)
  • Minocycline (Minocin)
  • Molnupiravir (Lagevrio)
  • Moxifloxacin (Avelox)
  • Nafcillin
  • Nitrofurantoin (Macrobid, Macrodantin)
  • Omadacycline (Nuzyra)
  • Oritavancin (Orbactiv, Kimyrsa)
  • Oseltamivir (Tamiflu)
  • Oteseconazole (Vivjoa)
  • Oxacillin
  • Nirmatrelvir/ ritonavir (Paxlovid)
  • Penicillin
  • Penicillin Skin Test
  • Phenazopyridine (AZO)
  • Piperacillin-tazobactam (Zosyn)
  • Pivmecillinam (Pivya)
  • Plazomicin (Zemdri)
  • Polymyxin B
  • Posaconazole (Noxafil)
  • Quinupristin-dalfopristin (Synercid)
  • Remdesivir (Veklury)
  • Rezafungin (Rezzayo)
  • Ribavirin
  • Rifabutin (Mycobutin)
  • Rifampin (Rifadin)
  • Secnidazole (Solosec)
  • Sofosbuvir/ velpatasvir/ voxilaprevir (Vosevi)
  • Sulopenem etzadroxil and Probenecid (Orlynvah)
  • Sotrovimab (Xevudy)
  • Sulbactam-durlobactam (Xacduro)
  • Sulfadiazine
  • Sulfamethoxazole-Trimethoprim (Bactrim)
  • Tecovirimat (TPOXX)
  • Tedizolid (Sivextro)
  • Telavancin (Vibativ)
  • Tigecycline (Tygacil)
  • Tobramycin
  • Tocilizumab (Actemra)
  • Valacyclovir (Valtrex)
  • Valganciclovir (Valcyte)
  • Vancomycin
  • Voriconazole (VFend)
  • Zidovudine (Retrovir)
  • Zoster vaccine recombinant, adjuvanted (Shingrix)

Recent

  • Pharmacy Student Study Strategies To Maximizing Learning In 2025 And Beyond
  • 5 Things To Know About Interpreting MRSA Nares Swab Results
  • Five Tidbits From The Largest International Meeting Of Clinical Microbiologists & Infectious Diseases Specialists In 2025
  • Five Things For Pharmacists To Know About Measles in 2025
  • 5 Things You Need To Know About The Learn Antibiotics Book Of Games

Search

Copyright 2016-2020 By Charlie Rose, LLC © · IDStewardship.com · Copyright · Privacy Policy · Terms · Contact