Quinupristin/Dalfopristin
Mechanism :
Inhibits bacterial protein synthesis by binding to different sites on the 50S bacterial ribosomal subunit thereby inhibiting protein synthesis.
Indication :
- Treatment of complicated skin and skin structure infections caused by methicillin susceptible Staphylococcus aureus or Streptococcus pyogenes.
- Off-label:
- MRSA bacteremia
- MRSA and MDR Enterococcus faecium infective endocarditis
Contraindications :
Hypersensitivity to quinupristin, dalfopristin, other streptogramins (e.g., pristinamycin, virginiamycin), or any component of the formulation.
Dosing :
≥12 years:
7.5 mg/kg IV every 8-12 hours for at least 7 days.
Adverse Effect :
Hyperbilirubinemia, local pain, inflammation, arthralgia, myalgia, thrombophlebitis, skin rash, increased LDH, CPK & GGT, anemia.
Interaction :
Cyclosporine: Quinupristin may increase the serum concentration of Cyclosporine.
Aripiprazole: CYP3A4 Inhibitors may increase the serum concentration of Aripiprazole.
Hepatic Dose :
Effects on liver not studied; pharmacokinetic data suggest adjustment may be necessary.