Topic
Dalfopristin
About: Dalfopristin is a research topic. Over the lifetime, 696 publications have been published within this topic receiving 26621 citations. The topic is also known as: RP-54476 & Dalfopristina.
Papers published on a yearly basis
Papers
More filters
TL;DR: Based on the data summarized here, the use of definitive identification methods and performing AST are recommended for clinically relevant strains of Corynebacteria and Microbacterium species.
23 citations
TL;DR: There is a need for new agents for the treatment of infections caused by vancomycin- and gentamicin-resistant Enterococcus faecium (VGREF) that may be resistant to all available antimicrobial agents, and the activity of quinupristin/dalfopristin may be enhanced against some strains by reversing the concentrations of its two components, quin upristin and dalfoprisin, as that may occur in vivo.
Abstract: There is a need for new agents, or combinations of agents, for the treatment of infections caused by vancomycin- and gentamicin-resistant Enterococcus faecium (VGREF) that may be resistant to all available antimicrobial agents. The early in-vitro activity of quinupristin/ dalfopristin (30:70)-an injectable streptogramin-encouraged us to test this agent against VGREF. By broth dilution, the MICs of quinupristin/dalfopristin against 38 isolates of VGREF ranged from 0.06 mg/L to 2.0 mg/L (mode 0.12 mg/L). The addition of 0.5 mg/L of ciprofloxacin significantly reduced the modal MIC of quinupristin/dalfopristin to 0.015 mg/L (P = 5.75 x 10 -8 ). Although the addition of 8.0 mg/L of teicoplanin or 4 mg/L of tetracycline did not significantly reduce the modal MIC, the lowest concentration of the MIC range was reduced from 0.06 to 0.015 mg/L. In broth, quinupristin/ dalfopristin had slow bactericidal activity against the four strains tested over 48 h, with a 1-2 log 10 cfu/mL reduction after 24 h in >1 mg/L of quinupristin/dalfopristin for two strains and >8 mg/L for the two other strains. A mixture of quinupristin/dalfopristin in a 70:30 ratio was more bactericidal: against one of the four strains 4-32 mg/L of the combination produced a further 0.5-1.0 log 10 reduction in cfu/mL after 24 h and there was a reduction of 6.0 log 10 cfu/mL after 48 h for another. By ultracentrifugation, the binding of 32 mg/L quinupristin/dalfopristin to human plasma protein was 90%, and in plasma broth, 32 mg/L of quinupristin/dalfopristin maintained bacteriostatic but not bactericidal activity. There is some useful synergy with ciprofloxacin and tetracycline, and the activity of quinupristin/dalfopristin may be enhanced against some strains by reversing the concentrations of its two components, quinupristin and dalfopristin, as that may occur in vivo.
23 citations
TL;DR: Clinicians should recognize that significant myopathy with daptomycin can occur without pronounced CK elevation, and the current package labeling recommends discontinuation of d aptomycin withsignificant myopathy symptoms in association with a CK elevation >1000 U/L or in patients without muscle pain and a CK >10 times normal.
Abstract: OBJECTIVETo report a case of muscle pain without pronounced creatine kinase (CK) elevation in a patient receiving daptomycin.CASE SUMMARYA 26-year-old African American woman had antibiotic intolerance to vancomycin and quinupristin/dalfopristin. She presented with methicillin-resistant Staphylococcus aureus endocarditis that was treated with intravenous daptomycin 6 mg/kg daily for 14 days. The patient developed muscle aches and pains with only a minor elevation (492 U/L) of CK; both resolved after daptomycin was discontinued.DISCUSSIONDaptomycin is a newly approved lipopeptide antibiotic derived from Streptomyces roseosporus with rapid bactericidal activity. Daptomycin has excellent coverage against gram-positive bacteria. The adverse effect profile has included rare reports of myopathy and elevated CK levels. Daptomycin is a promising agent with many potential applications. Once-daily dosing has diminished the preclinical incidence of myopathy. The current package labeling recommends discontinuation of ...
23 citations
TL;DR: Frequent monitoring of cyclosporine concentrations with attention to the need for dosage modification is recommended when initiating or discontinuing QND therapy.
Abstract: OBJECTIVE:To describe a case of a drug interaction between cyclosporine and quinupristin/dalfopristin (QND).CASE SUMMARY:A patient who had undergone a kidney transplant and was receiving chronic cyclosporine therapy was treated with the investigational streptogramin antibiotic QND. Baseline trough cyclosporine concentrations ranged from 80 to 105 ng/mL. Two and 3 days after initiation of QND therapy, trough cyclosporine concentrations increased to 261 and 291 ng/mL, respectively. Following discontinuation of QND, the cyclosporine blood concentration decreased and the dosage was subsequently increased to the previous regimen.DISCUSSION:A patient's cyclosporine blood concentration tripled 3 days after initiating therapy with QND. A one-third reduction in the cyclosporine dosage was required. QND was the most likely cause for the change in cyclosporine blood concentrations, probably due to inhibition of cyclosporine metabolism. This represents the first published case of an interaction between cyclosporine a...
23 citations
TL;DR: Antimicrobial resistance and the mechanisms implicated were studied in 148 clinical Enterococcus faecium isolates with a quinupristin-dalfopristin (Q/D) MIC > or =1 microg/mL and higher levels of resistance were detected for macrolide antibiotics.
23 citations