Glycopeptide-resistant Enterococcus faecium infections in paediatric livertransplant recipients: safety and clinical efficacy of quinupristin/dalfopristin

We describe our experience of quinupristin/dalfopristin for glycopeptide-re sistant Enterococcus faecium (GREF) infections in 19 paediatric liver trans plant recipients. The median patient age was 2 years and all were receiving immunosuppressive regimens. Quinupristin/dalfopristin was well tolerated a nd complete resolution of infection was seen in 74% of patients. Side-effec ts included reversible elevation of serum alkaline phosphatase, skin rash, itching, diarrhoea and vomiting, but therapy was not withdrawn from any pat ient. Quinupristin/dalfopristin appears safe and efficacious in critically ill immunocompromised children with renal or hepatic Impairment.