Successful administration of quinupristin/dalfopristin in the outpatient setting

Intravenous administration of quinupristin/dalfopristin outside the hospita l setting has not been reported previously. We describe 37 outpatients rece iving quinupristin/dalfopristin iv for infections including osteomyelitis, bacteraemia, abscesses and cellulitis. The most frequent aetiological patho gens found were Enterococcus faecium, Staphylococcus aureus and coagulase-n egative staphylococci. Patients received an average of 9 days therapy as in patients and 22 days as outpatients, Quinupristin/dalfopristin was administ ered using various access devices, most commonly peripherally inserted cent ral catheters and tunnelled central catheters. The bacteriological and clin ical success rates were both 89.2%, Five patients were readmitted to hospit al; one patient developed catheter-related bacteraemia. The most frequently reported non-venous adverse events were nausea (18.9% of patients), myalgi a (18.9%) and arthralgia (13.5%), Sixteen patients experienced venous acces s-related events, most commonly infusion pain, oedema and phlebitis, In thi s group of patients, for those who had difficult-to-treat infections, intra venous quinupristin/dalfopristin therapy was generally effective and safe o utside the hospital setting.