Quinupristin
Also known as: Pristinamycin IA derivative, Quinupristin, Quinupristin/dalfopristin, RP 57669, SC-42630, Synercid
Source Quinupristin at Peptiology
Save 10% with code PEPTI-BOSSRABBIT-10
Tapping Shop Now & Save 10% copies your 10% off code PEPTI-BOSSRABBIT-10 to your clipboard. Paste it at the Peptiology checkout to claim the discount.
Summary
Quinupristin is the streptogramin B component of the synergistic antibiotic combination dalfopristin/quinupristin (Synercid), used intravenously for serious Gram‑positive infections including MRSA.
Mechanism of Action
Binds to the 50S ribosomal subunit, inhibiting peptide chain elongation; synergistic with dalfopristin which enhances binding
Routes of Administration
Goals & Uses
- S. aureus bacteremia (including MRSA)Infectious DiseaseHigh
- Complicated skin and skin structure infections (cSSSI)AntibacterialHigh
- Nosocomial pneumonia due to Gram-positive organismsAntimicrobial / Infectious DiseaseLow
- Treatment of vancomycin-resistant Enterococcus faecium (VREF) infectionsAntimicrobial / Infectious DiseaseHigh
- Complicated skin and skin‑structure infectionsAntibacterialHigh
- MRSA infections (off-label)Antimicrobial / Infectious DiseaseModerate
Contraindications
- Concurrent use of drugs metabolized by CYP3A4 with narrow therapeutic indexDrug InteractionHigh
- Hypersensitivity to quinupristin, dalfopristin, or other streptograminsAllergyHigh
- Severe hepatic impairmentOrganModerateLiver function concerns
- Hypersensitivity to streptograminsAllergyHigh
Adverse Effects
- Elevated liver enzymes (AST/ALT)HepatotoxicityUncommon
- Infusion site reactions (pain, inflammation, thrombophlebitis)LocalCommon
- Nausea/vomitingGastrointestinalCommon
- Nausea and vomitingGastrointestinalCommon
- Rash/pruritusDermatologicCommon
- Arthralgia and myalgiaMusculoskeletalCommon
- Elevated hepatic transaminases (AST/ALT)HepaticUncommon
- QT prolongationCardiovascularRareExtended QT interval on ECG
- DiarrheaGastrointestinalCommonLoose or frequent stools
- HyperbilirubinemiaHepaticCommon
Drug Interactions
- CyclosporineHigh
- QT-prolonging agents (e.g., cisapride, terfenadine)High
- HMG-CoA reductase inhibitors (statins metabolized by CYP3A4)Moderate
- TacrolimusHigh
- DalfopristinLow
- Cytochrome P450 inhibitors (e.g., azole antifungals)Moderate
Population Constraints
- PregnancyReproductive SafetyRelative
- Hepatic impairmentOrgan FunctionRelative
- Pediatric patientsAgeRelative
- Patients on multiple CYP3A4-metabolized drugsPolypharmacyRelative
- Pregnancy (Category B)PregnancyRelative
- Pediatric patients <12 yearsAgeAbsolute
Regulatory Status
- European UnionApprovedApproved: Complicated skin and skin‑structure infections, S. aureus bacteremiaApproved under same combination product
- United StatesApprovedApproved: Complicated skin and skin‑structure infections, S. aureus bacteremiaApproved as dalfopristin/quinupristin (Synercid) IV infusion
- United KingdomApprovedApproved: Vancomycin-resistant Enterococcus faecium infections, Complicated skin and skin structure infectionsPreviously approved under EMA authorization; post-Brexit status follows UK licensing. Niche use in resistant Gram-positive infections.
Approved in the US (1999) and EU for skin/soft‑tissue infections and S. aureus bacteremia; not indicated for pediatric use <12 y; caution in hepatic or renal impairment.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Quinupristin?
Quinupristin is the streptogramin B component of the synergistic antibiotic combination dalfopristin/quinupristin (Synercid), used intravenously for serious Gram‑positive infections including MRSA.
What is Quinupristin used for?
Quinupristin is educationally associated with: S. aureus bacteremia (including MRSA), Complicated skin and skin structure infections (cSSSI), Nosocomial pneumonia due to Gram-positive organisms, Treatment of vancomycin-resistant Enterococcus faecium (VREF) infections, Complicated skin and skin‑structure infections, MRSA infections (off-label). Educational only — not medical advice.
How is Quinupristin administered?
Recorded routes of administration: Intravenous.
What are the potential side effects of Quinupristin?
Reported adverse effects include: Elevated liver enzymes (AST/ALT), Infusion site reactions (pain, inflammation, thrombophlebitis), Nausea/vomiting, Nausea and vomiting, Rash/pruritus, Arthralgia and myalgia, Elevated hepatic transaminases (AST/ALT), QT prolongation, Diarrhea, Hyperbilirubinemia. This list is not exhaustive — consult a qualified clinician.
Who should avoid Quinupristin?
Recorded contraindications: Concurrent use of drugs metabolized by CYP3A4 with narrow therapeutic index, Hypersensitivity to quinupristin, dalfopristin, or other streptogramins, Severe hepatic impairment, Hypersensitivity to streptogramins. Consult a qualified clinician before use.