Successful administration of quinupristin/dalfopristin in the outpatient setting

Abstract

Intravenous administration of quinupristin/dalfopristin outside the hospital setting has not been reported previously. We describe 37 outpatients receiving quinupristin/dalfopristin iv for infections including osteomyelitis, bacteraemia, abscesses and cellulitis. The most frequent aetiological pathogens found were Enterococcus faecium, Staphylococcus aureus and coagulase-negative staphylococci. Patients received an average of 9 days therapy as inpatients and 22 days as outpatients. Quinupristin/dalfopristin was administered using various access devices, most commonly peripherally inserted central catheters and tunnelled central catheters. The bacteriological and clinical success rates were both 89.2%. Five patients were readmitted to hospital; one patient developed catheter-related bacteraemia. The most frequently reported non-venous adverse events were nausea (18.9% of patients), myalgia (18.9%) and arthralgia (13.5%). Sixteen patients experienced venous access-related events, most commonly infusion pain, oedema and phlebitis. In this group of patients, for those who had difficult-to-treat infections, intravenous quinupristin/dalfopristin therapy was generally effective and safe outside the hospital setting.

The in vitro effects of quinupristin/dalfopristin, erythromycin and levofloxacin at low concentrations on the expression of different cell adhesion molecules on the surface of endothelial cells (Eahy926)

“…It has been reported that quinupristin/dalfopristin infusion causes an inflammatory reaction in 6-42% of the patients. Moreover, 14-40% report local pain, 6-17% show local oedema and 11-13% have unspecific reactions at the infusion site (Carver et al, 2003;Dever et al, 1996;Rehm et al, 2001;Rubinstein et al, 1999;Stahlmann, 2000). The cytotoxic potential of quinupristin/dalfopristin is supported by data obtained from the neutral red uptake cytotoxicity test in our laboratory, in which quinupristin/dalfopristin showed cytotoxic effects on cultured endothelial cells (Eahy926) at concentrations below 10 mg/l (data will be published elsewhere).…”

Determination of Macrolide, Lincosamide and Streptogramin B Resistance in Staphylococcus aureus Strains by Phenotypical Methods and Investigation of In Vitro Activity of Quinupristin/Dalfopristin

“…K/D, %30 kinupristin (Streptogramin B), %70 dalfopristin (Streptogramin A) içer-mektedir ve 50S ribozomal alt üniteye bağlana-rak hem peptid zincir uzamasını hem de peptidil transferaz enzimini inhibe ederek etki göster-mektedir. K/D Gram pozitif bakterilere, özellik-le de MRSA, viridans streptokok ve vankomisine dirençli Enterococcus faecium'a karşı in vitro etkinliğe sahiptir (3,(6)(7)(8)(9) . (10,11) .…”

The complete genome sequence of a high pristinamycin-producing strain Streptomyces pristinaespiralis HCCB10218

“…These two components are coproduced in a ratio of 30:70 (PI: PII) and show strong synergistic bacteriostatic activity (Rehm et al, 2001). The semisynthetic derivatives of PI and PII (quinupristin and dalfopristin) are approved as a therapeutic drug Synercid for the treatment of methicillin-resistant staphylococci and vancomycinresistant Enterococcus faecium strains (Barriere et al, 1994).…”