Classes
DEA Class; Rx
Common Brand Names; Synercid
- Streptogramins
Description
Streptogramin antibiotics isolated from Streptomyces pristinaespiralis. They act synergistically against susceptible bacteria when administered together. The combination has up to 16 times the activity of each agent alone. Used for vancomycin-resistant Enterococcus faecium bacteremia and for complicated skin and skin-structure infections due to Staphylococcus aureus.
Indications
Indicated for complicated skin and skin structure infections caused by Staphylococcus aureus (methicillin susceptible) or Streptococcus pyogenes
Bacteremia (Off-label)
- IDSA guidelines recommend for methicillin-resistant S aureus
Intravascular Catheter-associated Bacteremia (Off-label)
- IDSA guidelines recommend for methicillin-resistant coagulase negative staphylococci or ampicilin0 and vancomycin-resistant E Faecium)
Contraindications
Hypersensitivity to drug, or other streptogramins (eg, pristinamycin, virginiamycin)
Adverse Effects
- Local pain (40-44%)
- Inflammation at infusion site (38-42%)
- Hyperbilirubinemia (3-35%)
- Local edema (17-18%)
- Infusion site reaction (12-13%)
- Arthralgia (<1-8%)
- Nausea (3-5%)
- Myalgia (<1-5%)
- Vomiting (3% to 4%)
- Anemia (3%)
- Diarrhea (3%)
- incr LDH (3%)
- Rash (3%)
- Pain (2-3%)
- Headache (2%)
- Increased CPK (2%)
- Increased GGT (2%)
- Pruritus (2%)
- Thrombophlebitis (2%)
- Hyperglycemia (1%)
Warnings
Not active against E. faecalis
Caution in hepatic impairment
May cause arthralgias/myalgias, hyperbilirubinemia and phlebitis
Prolonged use may result in fungal or bacterial superinfection
Inhibits metabolism of drugs metabolized by CYP3A4
May prolong QTc when administered concurrently with cisapride
Prescribing drug in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to patient and increases risk of development of drug-resistant bacteria
Pregnancy and Lactation
Pregnancy Category: B
Lactation: unknown
Maximum Dosage
15 mg/kg/day IV is FDA-approved; however, doses up to 22.5 mg/kg/day IV have been used off-label.
15 mg/kg/day IV is FDA-approved; however, doses up to 22.5 mg/kg/day IV have been used off-label.
15 mg/kg/day IV is FDA-approved; however, doses up to 22.5 mg/kg/day IV have been used off-label.
12 years: 15 mg/kg/day IV is FDA-approved; however, doses up to 22.5 mg/kg/day IV have been used off-label.
1 to 11 years: Safety and efficacy have not been established; however, doses up to 22.5 mg/kg/day IV have been used off-label.
Safety and efficacy have not been established; however, doses up to 22.5 mg/kg/day IV have been used off-label.
Safety and efficacy have not been established.
How supplied
Quinupristin/dalfopristin
lyophilized powder for solution
- 500mg (150mg/350mg) per vial
