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Synercid

Quinupristin-dalfopristin (Synercid®) is a combination of two antibiotics used to treat infections by staphylococci and by vancomycin-resistant Enterococcus faecium. It is not effective against Enterococcus faecalis infections. more...

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

Administration

Intravenous, usually 7.5 mg every 8-12 hours

Mechanism of action

Dalfopristin inhibits the early phase of protein synthesis in the bacterial ribosome and quinupristin inhibits the late phase of protein synthesis. The combination of the two components acts synergistically and is more effective in vitro than each component alone.

Pharmacokinetics

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

Side effects

  1. Joint or muscle aches
  2. Nausea, diarrhea or vomiting
  3. Rash or itching
  4. Headache

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Synercid
From OB/GYN News, 11/15/99 by Elizabeth Mechcatie

(quinupristin/dalfopristin, Rhone-Poulenc Rorer)

A streptogramin antibiotic for infections caused by vancomycin-resistant Enterococcus faecinm (VREF) bacteria, when no alternative is available. Also for complicated skin and skin structure infections caused by methicillin-susceptible Staphylococcus aureus or Streptococcus pyogenes. Available since 1993 through the FDA's compassionate use program.

* Recommended Dosage: 7.5 mg/kg IV every 8 hours (no oral formulation).

* Special Considerations: Should not be used with drugs that can prolong the Q-Tc interval; must be used cautiously with P450 3A4 substrates like terfenadine.

* Comment: Because Synercid was approved under the FDA's accelerated approval program--applied to products that are used to treat serious or life-threatening conditions and that provide a "meaningful therapeutic" benefit over existing treatments--approval was based on trials using the surrogate end point of effectiveness, which in this case was clearance of VREF bacteremia.

A study evaluating clinical benefit with more traditional end points like resolution of the specific infection site is underway.

COPYRIGHT 1999 International Medical News Group
COPYRIGHT 2004 Gale Group

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