FOCUS ON QUINUPRISTIN DALFOPRISTIN - AN INVESTIGATIONAL STREPTOGRAMINANTIBIOTIC FOR THE TREATMENT OF MULTIDRUG-RESISTANT GRAM-POSITIVE INFECTIONS/

Quinupristin/dalfopristin is an investigational streptogramin antibiot ic whose in vitro spectrum of activity includes gram-positive pathogen s, certain gram-negative organisms, and select anaerobes. An FDA advis ory panel, acting primarily on data from noncomparative phase III tria ls and an emergency-use study, has recommended its approval for the tr eatment of nosocomial pneumonia, vancomycin-resistant Enterococcus fae cium (VREF) infections, and skin and skin-structure infections. Venous adverse effects and transient liver enzyme elevations have been the m ajor adverse effects reported. Quinupristin/dalfopristin appears to be an important new option for the treatment of VREF and methicillin-res istant Staphylococcal aureus infections, but the need. to avoid develo pment of resistance should preclude its use as first-line therapy. Ong oing studies will likely better define its appropriate clinical role.