Quinupristin and dalfopristin are streptogramin antibiotics, which, like macrolides and lincosamides, inhibit the synthesis of bacterial proteins.
Streptococci and staphylococci, including strains resistant to other antibiotic classes
Some gram-negative anaerobic bacilli
Peptostreptococcus species
Atypical respiratory pathogens (Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila)
D/Q inhibits Enterococcus faecium, including vancomycin-resistant strains. Enterococcus faecalis is resistant.
D/Q is given via a central IV catheter because phlebitis frequently occurs when D/Q is given via a peripheral vein. Up to 30% of patients develop significant myalgias. D/Q may cause hyperbilirubinemia.
Dosage reduction is required for severe hepatic insufficiency but not for renal insufficiency.
Safety Warning for Quinupristin and Dalfopristin
D/Q may inhibit the metabolism of medications that are metabolized by the cytochrome P-450 (CYP450) 3A4 isoenzyme system.