Quinupristin/Dalfopristin: The First Available Macrolide-Lincosamide-Streptogramin Antibiotic (Pharmacology Notes) (Clinical Report‪)‬

Quinupristin/dalfopristin (Synercid, Rhone-Poulenc Rorer, Collegeville, Penn) is a member of the macrolide-lincosamide-streptogramin class of antibiotics. This new drug is a combination of 2 products derived from pristinamycin. The product is provided as a 30:70 ratio of quinupristin (pristinamycin I A, a group B streptogramin) and dalfopristin (pristinamycin II A, a group A streptogramin) (1, 2). The agent was approved by the US Food and Drug Administration in the second quarter of 1998 and is now available from the manufacturer. The delay was due in part to the complicated and time-consuming manufacturing process that takes place in 4 different manufacturing facilities worldwide and requires approximately 9 months to complete (3). Quinupristin/dalfopristin received approval for use in adults for the treatment of infections caused by susceptible strains of vancomycin-resistant Enterococcus faecium (VREF) and for the treatment of complicated skin and skin structure infections caused by Staphylococcus aureus (methicillin-susceptible) or Streptococcus pyogenes (4).