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Quinupristin/dalfopristin (trade name Synercid) is a combination of two antibiotics used to treat infections by staphylococci and by vancomycin-resistant Enterococcus faecium.

Quinupristin and dalfopristin are both streptogramin antibiotics, derived from pristinamycin. Quinupristin is derived from pristinamycin IA; dalfopristin from pristinamycin IIA. They are combined in a weight-to-weight ratio of 30% quinupristin to 70% dalfopristin.

Administration[edit]

Intravenous, usually 7.5 mg/kg every 8–12 hours

Mechanism of action[edit]

Quinupristin and dalfopristin are protein synthesis inhibitors in a synergistic manner. While each of the two is only a bacteriostatic agent, the combination shows bactericidal activity.

Dalfopristin binds to the 23S portion of the 50S ribosomal subunit, and changes the conformation of it, enhancing the binding of quinupristin^[1] by a factor of about 100. In addition, it inhibits peptidyl transfer.^[1]
Quinupristin binds to a nearby site on the 50S ribosomal subunit and prevents elongation of the polypeptide,^[1] as well as causing incomplete chains to be released.^[1]

Pharmacokinetics[edit]

Clearance by the liver, half-life 1–3 hours (with persistence of effects for 9–10 hours).

Side effects[edit]

Joint aches (arthralgia) or muscle aches (myalgia)
Nausea, diarrhea or vomiting
Rash or itching
Headache
Phlebitis
Hyperbilirubinemia

Drug interactions[edit]

Inhibits P450 and enhances the effects of terfenadine, astemizole, indinavir, midazolam, Ca channel blockers, warfarin, cisapride and cyclosporine.

References[edit]

^ ^a ^b ^c ^d Page 212 in: Title: Hugo and Russell's pharmaceutical microbiology Authors: William Barry Hugo, Stephen P. Denyer, Norman A. Hodges, Sean P. Gorman Edition: 7, illustrated Publisher: Wiley-Blackwell, 2004 ISBN 0-632-06467-6, ISBN 978-0-632-06467-0 Length: 481 pages

UpToDate Contents

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1. メチシリン耐性黄色ブドウ球菌およびバンコマイシン耐性腸球菌の治療のための抗菌薬の薬理学 pharmacology of antimicrobial agents for treatment of methicillin resistant staphylococcus aureus and vancomycin resistant enterococcus
2. 腸球菌感染症の治療 treatment of enterococcal infections
3. 小児におけるメチシリン耐性黄色ブドウ球菌感染：侵襲性感染症の治療 methicillin resistant staphylococcus aureus in children treatment of invasive infections
4. 腸球菌における抗菌薬耐性の機構 mechanisms of antibiotic resistance in enterococci
5. 成人における侵襲性メチシリン耐性黄色ブドウ球菌感染症の治療 treatment of invasive methicillin resistant staphylococcus aureus infections in adults

English Journal

Prevalence of antimicrobial resistance in faecal enterococci from vet-visiting pets and assessment of risk factors.

Leite-Martins L1, Mahú MI2, Costa AL3, Bessa LJ4, Vaz-Pires P3, Loureiro L5, Niza-Ribeiro J6, de Matos AJ7, Martins da Costa P4.
The Veterinary record.Vet Rec.2015 Jun 27;176(26):674. doi: 10.1136/vr.102888. Epub 2015 Jun 15.
The objective of this study was to determine the prevalence of antimicrobial resistance (AMR) exhibited by enterococci isolated from faeces of pets and its underlying risk factors. From September 2009 to May 2012, rectal swabs were collected from 74 dogs and 17 cats, selected from the population of
PMID 26078332

Prevalence, species distribution and antimicrobial resistance patterns of methicillin-resistant staphylococci in Lithuanian pet animals.

Ruzauskas M1, Couto N2, Kerziene S3, Siugzdiniene R4, Klimiene I5, Virgailis M6, Pomba C7.
Acta veterinaria Scandinavica.Acta Vet Scand.2015 Jun 2;57:27. doi: 10.1186/s13028-015-0117-z.
BACKGROUND: The bacterial genus Staphylococcus consists of many species that causes infections in pet animals. Antimicrobial resistant staphylococci cause infections that are difficult to treat and they are important from the point of one health perspective. The aim of this study was to determine th
PMID 26032539

Genotyping of community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) in a tertiary care centre in Mysore, South India: ST2371-SCCmec IV emerges as the major clone.

Rajan V1, Schoenfelder S2, Ziebuhr W2, Gopal S3.
Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases.Infect Genet Evol.2015 Jun 1. pii: S1567-1348(15)00231-2. doi: 10.1016/j.meegid.2015.05.032. [Epub ahead of print]
The burden of community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) is on the rise in population and clinical settings on account of the adaptability and virulence traits of this pathogen. We characterized 45 non-duplicate CA-MRSA strains implicated mainly in skin and soft tissu
PMID 26044198

Japanese Journal

バンコマイシン耐性腸球菌 (特集外科領域における耐性菌)

日本外科感染症学会雑誌 10(3), 293-298, 2013-06
NAID 40019764950

Isolation and Molecular Characterization of Methicillin-Resistant Staphylococci from Horses, Personnel and Environmental Sites at an Equine Hospital in Turkey

Journal of Veterinary Medical Science 74(12), 1583-1588, 2012
NAID 130001879704

各種抗菌薬に対する２００４年臨床分離好気性グラム陽性球菌および嫌気性菌の感受性サーベイランス

日本化学療法学会雑誌 56(5), 543-561, 2008
NAID 130004102773

Related Pictures

Synercid - patient information, description, dosage and directions. quinupristin and dalfopristin Intravenous - patient information, description, dosage Dalfopristin; Quinupristin: Information from Answers.com Methicillin Resistant Staphylococcus aureus (MRSA) - ppt video online download Quinolonas. - ppt descargar Quinupristin-Dalfopristin - wikidoc WBR0636 - wikidoc The ABC’s of Antibiotics - ppt download

★リンクテーブル★

リンク元	「ダルホプリスチン」「キヌプリスチン・ダルホプリスチン」
拡張検索	「quinupristin-dalfopristin-resistant Enterococcus」
関連記事	「dalfopristin」

「ダルホプリスチン」

Quinupristin/dalfopristin
Combination of
Quinupristin	Antibiotic
Dalfopristin	Antibiotic
Clinical data
Pregnancy cat.	B (U.S.)
Legal status	℞-only (U.S.)
Routes	IV
Identifiers
CAS number	126602-89-9
ATC code	J01FG02
PubChem	CID 23724510
ChemSpider	21106373
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