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Quinupristin and Dalfopristin

By

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Last full review/revision May 2020| Content last modified May 2020
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Quinupristin and dalfopristin are streptogramin antibiotics, which, like macrolides and lincosamides, inhibit the synthesis of bacterial proteins.

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

Q/D inhibits Enterococcus faecium, including vancomycin-resistant strains. Enterococcus faecalis is resistant.

Q/D is given via a central IV catheter because phlebitis frequently occurs when Q/D is given via a peripheral vein. Up to 30% of patients develop significant myalgias.

Dosage reduction is required for severe hepatic insufficiency but not for renal insufficiency.

Safety Warning

Q/D may inhibit the metabolism of drugs that are metabolized by the cytochrome P-450 (CYP450) 3A4 isoenzyme system.

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