Quinupristin–dalfopristin: a streptogramin antibiotic

Over the past 10 years, hospitals have witnessed the growing resistance of gram-positive organisms to many antibiotics. In September 1999, quinupristin–dalfopristin (Synercid) was approved by the U.S. Food and Drug Administration. It is the first injectable streptogramin antibiotic and is indicated for the treatment of serious infections (bacteremia and complicated skin infections) caused by vancomycin-resistant Enterococcus faecium (VREF) and methicillin-susceptible Staphylococcus aureus and Streptococcus pyogens. The dosage is 7.5 mg/kg intravenously every 8 hours for VREF infections and every 12 hours for skin and skin structure infections. The most common side effect is pain and inflammation at the infusion site. Other side effects include nausea, arthralgias, myalgias, diarrhea, vomiting, and rash. The average wholesale price of quinupristin–dalfopristin is $107 for a 500-mg vial.