Infectious Disease Compendium

Quinupristin/Dalfopristin (Synercid®)

Dosing

CrCl Formula

CrCl > 80: 7 mg / kg q 8 h.

CrCl 80-50: 7 mg / kg q 8 h.

CrCl 50-10: ?

CrCl < 10: ?

Hemodialysis:

Peritoneal dialysis:

Important side effects

Arthralgias (esp in liver disease), myalgias, diarrhea, headache, hyperbilirubinemia (common), infusion site inflammation, nausea, vomiting, rash, thrombophlebitis.

Important drug interactions

Alfuzosin, amlodipine, astemizole, atorvastatin, carbamazepine, cerivastatin, cisapride, cyclosporine, delavirdine, diazepam, digoxin, diltiazem, disopyramide, docetaxel, eletriptan, felodipine, fluvastatin, indinavir, isradipine, lacidipine, lidocaine, lovastatin, manidipine, methylprednisolone, midazolam, nevirapine, nicardipine, nifedipine, nilvadipine, nimodipine, nisoldipine, nitrendipine, paclitaxel, pravastatin, quinidine, ritonavir, simvastatin, tacrolimus, terfenadine, verapamil, vinca alkaloids.

Rants and Screeds

Pearls

If the staphylococcus is resistant to erythromycin, it is also resistant to the dalfopristin and the drug goes from bacteriocidal-ish to static. NOT active against Enterococcus faecalis.

Treatment of choice

Use for

VRE and MRSA when vancomycin is not an option. I would say it is at the end of the list for drugs to use against MRSA.

Don't use for

Class