Streptogramins

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Quinupristin-dalfopristin

• synergistic combination of two streptogramins. Both are water-soluble derivatives of streptogramins produced by Streptomyces pistinaespiralis
• the two components are structurally unrelated and bind to distinct sites on the 50S ribosomal subunit. Cooperate to inhibit protein synthesis
• Active against most gram positive bacteria and most respiratory pathogens including pneumococci, Mycoplasma pneumoniae, Legionella pneumophilia, Chlamydia pneumoniae. More importantly the combination is also active against:
  • 90% of Staph. aureus and coagulase negative staphylococci including methicillin resistant strains
  • pencillin resistant pneumococci
  • Enterococcus faecium including strains which are resistant to ampicillin, gentamicin and vancomycin. NB not active against E. faecalis
• Although each component is only bacteriostatic the combination is bactericidal
• Similar efficacy to vancomycin

Adverse effects

Related to administration via peripheral vein

• inflammation, pain, oedema, infusion site reaction, thrombophlebitis

Non-venous adverse effects

• nausea, diarrhoea, vomiting
• rash
• headache
• pain. Ill defined focal or generalized discomfort
• pruritus
• arthralgia, myalgia
• asthenia
• conjugated hyperbilirubinaemia

Drug interactions

©Charles Gomersall, October, 2009 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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