Quinupristin/dalfopristin: Difference between revisions
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==Uses== | ==Uses== | ||
* | *[[Antibiotic]]: treatment of vancomycin-resistant Enterococcus faecium, as well as nosocomial pneumonias and infections secondary to IV catheters (1) | ||
==Administration== | ==Administration== | ||
Line 44: | Line 44: | ||
*Excretion: | *Excretion: | ||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | |||
{| class="wikitable" | |||
| align="center" style="background:#f0f0f0;"|'''Group''' | |||
| align="center" style="background:#f0f0f0;"|'''Organism''' | |||
| align="center" style="background:#f0f0f0;"|'''Sensitivity''' | |||
|- | |||
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S''' | |||
|- | |||
| ||[[Strep. Pneumoniae]]||'''S''' | |||
|- | |||
| ||[[Viridans strep]]||X1 | |||
|- | |||
| ||Strep. anginosus gp||X1 | |||
|- | |||
| ||[[Enterococcus faecalis]]||R | |||
|- | |||
| ||[[Enterococcus faecium]]||'''S''' | |||
|- | |||
| ||[[MSSA]]||'''S''' | |||
|- | |||
| ||[[MRSA]]||'''S''' | |||
|- | |||
| ||[[CA-MRSA]]||'''S''' | |||
|- | |||
| ||[[Staph. Epidermidis]]||'''S''' | |||
|- | |||
| ||[[C. jeikeium]]||'''S''' | |||
|- | |||
| ||[[L. monocytogenes]]||'''S''' | |||
|- | |||
| Gram Negatives||[[N. gonorrhoeae]]||X2 | |||
|- | |||
| ||[[N. meningitidis]]||R | |||
|- | |||
| ||[[Moraxella catarrhalis]]||'''S''' | |||
|- | |||
| ||[[H. influenzae]]||I | |||
|- | |||
| ||[[E. coli]]||R | |||
|- | |||
| ||[[Klebsiella]] sp||R | |||
|- | |||
| ||E. coli/Klebsiella ESBL+||R | |||
|- | |||
| ||E coli/Klebsiella KPC+||R | |||
|- | |||
| ||[[Enterobacter]] sp, AmpC neg||R | |||
|- | |||
| ||[[Enterobacter]] sp, AmpC pos||R | |||
|- | |||
| ||[[Serratia]] sp||X1 | |||
|- | |||
| ||Serratia marcescens||X1 | |||
|- | |||
| ||[[Salmonella]] sp||R | |||
|- | |||
| ||[[Shigella]] sp||R | |||
|- | |||
| ||[[Proteus mirabilis]]||X1 | |||
|- | |||
| ||[[Proteus vulgaris]]||X1 | |||
|- | |||
| ||[[Providencia sp.]]||X1 | |||
|- | |||
| ||[[Morganella sp.]]||X1 | |||
|- | |||
| ||[[Citrobacter freundii]]||X1 | |||
|- | |||
| ||[[Citrobacter diversus]]||X1 | |||
|- | |||
| ||[[Citrobacter sp.]]||X1 | |||
|- | |||
| ||[[Aeromonas sp]]||X1 | |||
|- | |||
| ||[[Acinetobacter sp.]]||X1 | |||
|- | |||
| ||[[Pseudomonas aeruginosa]]||R | |||
|- | |||
| ||[[Burkholderia cepacia]]||X1 | |||
|- | |||
| ||[[Stenotrophomonas maltophilia]]||X1 | |||
|- | |||
| ||[[Yersinia enterocolitica]]||X1 | |||
|- | |||
| ||[[Francisella tularensis]]||X1 | |||
|- | |||
| ||[[Brucella sp.]]||X1 | |||
|- | |||
| ||[[Legionella sp.]]||X1 | |||
|- | |||
| ||[[Pasteurella multocida]]||X1 | |||
|- | |||
| ||[[Haemophilus ducreyi]]||X1 | |||
|- | |||
| ||[[Vibrio vulnificus]]||X1 | |||
|- | |||
| Misc||[[Chlamydophila sp]]||X2 | |||
|- | |||
| ||[[Mycoplasm pneumoniae]]||'''S''' | |||
|- | |||
| ||[[Rickettsia sp]]||X1 | |||
|- | |||
| ||[[Mycobacterium avium]]||R | |||
|- | |||
| Anaerobes||[[Actinomyces]]||X1 | |||
|- | |||
| ||[[Bacteroides fragilis]]||X1 | |||
|- | |||
| ||[[Prevotella melaninogenica]]||'''S''' | |||
|- | |||
| ||[[Clostridium difficile]]||I | |||
|- | |||
| ||[[Clostridium (not difficile)]]||X2 | |||
|- | |||
| ||[[Fusobacterium necrophorum]]||X1 | |||
|- | |||
| ||[[Peptostreptococcus sp.]]||X1 | |||
|} | |||
===Key=== | |||
{{Template:Antibacterial Spectra Key}} | |||
==References== | ==References== | ||
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*2. U.S. Food and Drug Administration. Synercid I.V. November 2007. Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/050748s008,050747s008lbl.pdf | *2. U.S. Food and Drug Administration. Synercid I.V. November 2007. Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/050748s008,050747s008lbl.pdf | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:ID]] |
Latest revision as of 22:14, 23 September 2019
Uses
- Antibiotic: treatment of vancomycin-resistant Enterococcus faecium, as well as nosocomial pneumonias and infections secondary to IV catheters (1)
Administration
- Dosage Forms: 500mg vials, diluted into 250 mL and given over 60 mins
- Routes of Administration: IV
- Common Trade Names: Synercid
Adult Dosing
- VRE: 7.5mg/kg IV q8 hrs for minimum 7 days
- skin infections: 7.5mg/kg IV q12 hrs for minimum 7 days
Pediatric Dosing
- safety and efficacy has not been studied in children
Special Populations
- Pregnancy Rating: B
- Lactation risk: unknown whether secreted in human breast milk. Caution should be exercised when administering to nursing mothers. (2)
Renal Dosing
- no adjustments for renal impairment
Hepatic Dosing
- dosage may need to be adjusted in patients with cirrhosis, however specific dose modification is not known at this time (2)
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
- pain and inflammation at infusion site
- arthralgias
- nausea/vomiting/diarrhea
- rash
- headache
- pruritus
Pharmacology
- Half-life: Quinupristin: 3 hrs; Dalfopristin: 1 hr
- Metabolism: significantly interacts with the CYP 3A4 system.
- Excretion:
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
References
- 1. JP Manzanella. "Quinupristin-Dalfopristin: A New Antibiotic for Severe Gram-Positive Infections." American Family Physician. 2001 Dec 1;64(11):1863-1867.
- 2. U.S. Food and Drug Administration. Synercid I.V. November 2007. Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/050748s008,050747s008lbl.pdf
- ↑ Sanford Guide to Antimicrobial Therapy 2014