|Pronunciation||kwi NYOO pris tin / dal FOE pris tin|
|Drug class||Streptogramin antibiotics|
|Main uses||Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE)|
|Side effects||Pain at the site of injection, nausea, diarrhea, joint and muscle pain, headache, rash|
Quinupristin/dalfopristin, sold under the brand name Synercid, is a combination of two antibiotics used to treat infections by staphylococci, including Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE). It is not very effective against VRE. It is given by gradual injection into a vein.
Common side effects include pain at the site of injection, nausea, diarrhea, joint and muscle pain, headache, and rash. Other side effects may include Clostridioides difficile infection and anaphylaxis. Quinupristin and dalfopristin are both streptogramin antibiotics, made from from pristinamycin.
The combination was approved for medical use in the United States in 1999. In the United States 10 doses of 350 mg/150 mg costs about 4,900 USD as of 2021. In the United Kingdom it is no longer available as of 2018.
- Joint aches or muscle aches
- Nausea, diarrhea or vomiting
- Rash or itching
Mechanism of action
- Dalfopristin binds to the 23S portion of the 50S ribosomal subunit, and changes the conformation of it, enhancing the binding of quinupristin by a factor of about 100. In addition, it inhibits peptidyl transfer.
- Quinupristin binds to a nearby site on the 50S ribosomal subunit and prevents elongation of the polypeptide, as well as causing incomplete chains to be released.
Excretion: Quinupristin: 85% feces, 15% urine; Dalfopristin: 81% feces, 19% urine
They are combined in a weight-to-weight ratio of 30% quinupristin to 70% dalfopristin.
Society and culture
Quinupristin is derived from pristinamycin IA; dalfopristin from pristinamycin IIA.
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