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Quinupristin-Dalfopristin

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141. Enterococcal Infections

). When identified, infected patients are strictly isolated. Recommended treatment includes streptogramins ( quinupristin/dalfopristin for E. faecium only) and oxazolidinones ( linezolid , tedizolid ). Daptomycin and tigecycline have in vitro activity against VRE and may be off-label treatment options. Beta-lactamase–producing enterococci are occasionally encountered, particularly when large numbers of organisms are present (eg, in endocarditis vegetation). Resistance may be present clinically even

2013 Merck Manual (19th Edition)

142. Streptococcal Infections

-resistant enterococci: Streptogramins ( quinupristin/dalfopristin ), oxazolidinones ( linezolid ), lipopeptide ( daptomycin ) S. gallolyticus (formerly S. bovis biotype I) Colonic adenomas or carcinomas, endocarditis Viridans* S. mutans , S. sanguis , S. salivarius , S. mitior , S. anginosus (formerly S milleri ), S. constellatus , S. intermedius Alpha or gamma Endocarditis, bacteremia, meningitis, localized infection, abscesses (particularly S. anginosus ) Penicillin, ampicillin , vancomycin (plus

2013 Merck Manual (19th Edition)

143. Overview of Antibacterial Drugs

as a single dose N/A N/A 1200 mg as a single dose Quinupristin/dalfopristin N/A 7.5 mg/kg IV q 8–12 h 7.5 mg/kg IV q 8 h N/A 7.5 mg/kg IV q 12 h for complicated skin or skin structure infection or 7.5 mg/kg q 8 h for serious infections 7.5 mg/kg IV q 8–12 h Rifampin c For TB (as part of a 3- or 4-drug regimen) 0.6 g q 24 h 0.6 g IV q 24 h N/A 5–10 mg/kg q 12 h or 10–20 mg/kg q 24 h 10–20 mg/kg IV q 24 h 0.3–0.6 g IV or po q 24 h For meningococcal exposure 0.6 g q 12 h for 4 doses N/A N/A Age ≥ 1 mo: 10 mg (...) concentrations) Tetracycline Beta-lactams (including carbapenems, cephalosporins, and penicillins) (including tedizolid ) Phenytoin Ciprofloxacin Isoniazid Some macrolides ( erythromycin , clarithromycin , telithromycin ) Rifampin (decreased phenytoin levels) Sulfonamides Azithromycin Aminoglycosides Clindamycin Doxycycline Fluoroquinolones except ciprofloxacin Linezolid Metronidazole Quinulpristine/dalfopristin Trimethoprim Vancomycin Theophylline Ciprofloxacin Clarithromycin Erythromycin Rifampin

2013 Merck Manual (19th Edition)

144. Lincosamides, Oxazolidinones, and Streptogramins

-resistance occurs among the following antibiotics because they bind to the same target: Macrolides Clindamycin Quinupristin Telithromycin (to some extent) However, cross-resistance does not occur between these antibiotics and dalfopristin and oxazolidinones, which bind to different targets on the 50S ribosomal subunit. Last full review/revision July 2018 by Brian J. Werth, PharmD NOTE: This is the Professional Version. CONSUMERS: © 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc

2013 Merck Manual (19th Edition)

145. Docetaxel

in clearance of M4 by 25% is observed in patients taking phenytoin and phenobarbital, common anticonvulsants. Common and/or likely drug-drug combinations and known side effects from drug interactions Drug interacting with docetaxel Adverse effects from interaction Cisplatin Increased risk of delayed neuropathy Cyclosporine, dalfopristin, erythromycin, itraconazole, ketoconazole, quinupristin, terfenadine, troleandomycin Increased risk of docetaxel toxicity including some or all of the following: anaemia

2012 Wikipedia

146. Characterization of two new genes, vgaD and vatG, conferring resistance to streptogramin A in Enterococcus faecium. (PubMed)

Characterization of two new genes, vgaD and vatG, conferring resistance to streptogramin A in Enterococcus faecium. We characterized two new streptogramin A resistance genes from quinupristin-dalfopristin-resistant Enterococcus faecium JS79, which was selected from 79 E. faecium isolates lacking known genes encoding streptogramin A acetyltransferase. A 5,650-bp fragment of HindIII-digested plasmid DNA from E. faecium JS79 was cloned and sequenced. The fragment contained two open reading frames (...) vgaD. vgaD is located 65 bp upstream from vatH, [corrected] was detected together with vatH [corrected] in 12 of 179 quinupristin-dalfopristin-resistant E. faecium isolates, and was located on the same plasmid. Also, the 5.6-kb HindIII-digested fragment which was observed in JS79 was detected in nine vgaD- and vatH-containing [corrected] E. faecium isolates by Southern hybridization. Therefore, it was expected that these two genes were strongly correlated with each other and that they may

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2010 Antimicrobial Agents and Chemotherapy

147. In vitro activity of the new multivalent glycopeptide-cephalosporin antibiotic, TD-1792, against vancomycin non-susceptible staphylococci isolates. (PubMed)

-intermediate Staphylococcus spp. (VISS), heteroresistant VISS (hVISS), and vancomycin-resistant S. aureus (VRSA). The TD-1792, vancomycin, daptomycin, linezolid, and quinupristin-dalfopristin MICs and minimum bactericidal concentrations (MBCs) were determined for 50 VISS/hVISS isolates and 3 VRSA isolates. Time-kill experiments (TKs) were then performed over 24 h with two vancomycin-intermediate S. aureus strains and two VRSA strains, using each agent at multiples of the MIC. TD-1792 and daptomycin were (...) also evaluated in the presence and absence of 50% human serum to determine the effects of the proteins on their activities. Most of the VISS/hVISS isolates were susceptible to all agents except vancomycin. TD-1792 exhibited the lowest MIC values (MIC(90) = 0.125 microg/ml), followed by quinupristin-dalfopristin and daptomycin (MIC(90) = 1 microg/ml) and then linezolid (MIC(90) = 2 microg/ml). The presence of serum resulted in a 2- to 8-fold increase in the TD-1792 and daptomycin MIC values. In TKs

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2010 Antimicrobial Agents and Chemotherapy

148. Dose-finding Study of New Tolvaptan Formulation in Subjects With ADPKD

taking CYP3A4 inhibitors, with the exception of amiodarone, taken within 30 days of dosing (eg, amprenavir, atorvastatin, aprepitant, chloramphenicol [not eye drops], cimetidine, clarithromycin, clotrimazole [if used orally], danazol, delavirdine, diltiazem, erythromycin, fluconazole, fluvoxamine, indinavir, isoniazid, itraconazole, josamycin, ketoconazole, nelfinavir, nefazadone, quinupristin/dalfopristin, ritonavir, saquinavir, troleandomycin, verapamil) Subjects taking CYP3A4 inducers taken within

2010 Clinical Trials

149. Treatment Algorithm to Reduce the Use of Vancomycin in Adults With Blood Stream Infection

calendar days immediately preceding the calendar day that the initial positive blood culture was drawn: If methicillin susceptibility of the isolate is unknown at the time of enrollment: vancomycin; daptomycin; telavancin; tigecycline; linezolid (in either oral or IV administration); quinupristin/dalfopristin; piperacillin/tazobactam; penicillin; nafcillin; oxacillin; cloxacillin; cefazolin, ceftriaxone, ceftaroline, dalbavancin, oritavancin, tedizolid, and levofloxacin or equivalent fluoroquinolone (...) (in either oral or IV administration) Note: ciprofloxacin is not an exclusion criteria. If the staphylococcal isolate is known to be methicillin resistant: vancomycin; daptomycin; telavancin; tigecycline; linezolid (in either oral or IV administration), quinupristin/dalfopristin, dalbavancin, oritavancin, tedizolid, and ceftaroline. Note: patients who have developed bacteremia after at least 7 days of prophylaxis with oral antibiotics have by definition failed prophylaxis and the oral antibiotic can

2010 Clinical Trials

150. Comparison of Antimicrobial Agents as Therapy for Experimental Endocarditis Caused by Methicillin-Resistant Staphylococcus aureus (PubMed)

Comparison of Antimicrobial Agents as Therapy for Experimental Endocarditis Caused by Methicillin-Resistant Staphylococcus aureus We used an experimental rat model to compare the therapeutic efficacy of teicoplanin, linezolid, and quinupristin/dalfopristin with that of vancomycin as standard therapy for infective endocarditis.Aortic endocarditis was induced in rats by insertion of a polyethylene catheter into the left ventricle, followed by intravenous inoculation of 106 colony-forming units (...) of methicillin-resistant Staphylococcus aureus 24 hours later. Forty-eight hours after bacterial challenge, intravenous antibiotic therapies were initiated. There were 6 groups of 8 rats each: uninfected control; infected, untreated control; vancomycin-treated (40 mg/kg twice daily); teicoplanin-treated (20 mg/kg twice daily after a loading dose of 40 mg/kg); linezolid-treated (75 mg/kg 3 times daily for 1 day, then 75 mg/kg twice daily); and quinupristin/dalfopristin-treated (30 mg/kg twice daily

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2010 Texas Heart Institute Journal

151. Antibacterial Susceptibility Patterns and Cross-Resistance of Methicillin Resistant and Sensitive Staphyloccus Aureus Isolated from the Hospitalized Patients in Shiraz, Iran (PubMed)

wound samples. All of 200 MSSA isolates were sensitive to oxacillin, vancomycin, tecoplanin, rifampin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid. A gradient of reduced susceptibility of MSSA to cephalexin, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin were evident. MRSA isolates were sensitive to vancomycin, tecoplanin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid, while reduced susceptibility of them to rifampin, co

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2010 Brazilian Journal of Microbiology

152. Telavancin activity against Gram-positive bacteria isolated from respiratory tract specimens of patients with nosocomial pneumonia. (PubMed)

enterococci non-susceptible to vancomycin (all Enterococcus faecium), telavancin was active against isolates exhibiting a VanB phenotype (MIC, 0.06-0.12 mg/L), but less potent against VanA strains (MIC, ≥ 2 mg/L).Telavancin demonstrated equal or greater potency than the comparators (vancomycin, teicoplanin, daptomycin, linezolid and quinupristin/dalfopristin) against Gram-positive pathogens implicated in NP. Telavancin showed elevated MIC values only against enterococcus isolates showing a VanA phenotype

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2010 Journal of Antimicrobial Chemotherapy

153. Assessment of linezolid resistance mechanisms among Staphylococcus epidermidis causing bacteraemia in Rome, Italy. (PubMed)

and/or Ala157Arg appeared responsible for the elevated linezolid MIC, since adjacent alterations have been associated with resistance. L4 Asn158Ser has been reported in a linezolid-susceptible isolate and Lys68Arg detected here did not seem to provide an additive effect. Acquisition of cfr markedly increased (8- to 16-fold) the linezolid MICs. vga(A) was associated with higher MICs of quinupristin/dalfopristin and retapamulin.

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2010 Journal of Antimicrobial Chemotherapy

154. DNA methylase modifications and other linezolid resistance mutations in coagulase-negative staphylococci in Italy. (PubMed)

expressed methylase activity at position A2503 mediated by the cfr gene. Overall, the isolates showed reduced susceptibility to vancomycin (MICs 1-2 mg/L) and 11 of the 33 isolates showed no susceptibility to teicoplanin. These strains were also resistant to chloramphenicol (28 of 33), lincomycin (24 of 33), erythromycin (17 of 33) and quinupristin/dalfopristin (13 of 33). S. epidermidis isolates, showing mutations or methylase modifications, belonged to different PFGE profiles and to two different

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2010 Journal of Antimicrobial Chemotherapy

155. BSAC standardized disc susceptibility testing method (version 8). (PubMed)

for clarithromycin, clindamycin, erythromycin, quinupristin/dalfopristin, trimethoprim UTI, nitrofurantoin UTI and rifampicin (Table 11); Streptococcus pneumoniae MIC and zone diameter BPs for azithromycin, clarithromycin, erythromycin, co-trimoxazole, linezolid, rifampicin and telithromycin (Table 12); addition of streptomycin recommendations for enterococci (Table 13); enterococcal MIC and zone diameter BPs for quinupristin/dalfopristin, nitrofurantoin UTI and trimethoprim UTI (Table 13); beta-haemolytic

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2009 Journal of Antimicrobial Chemotherapy

156. ACTIVITY OF TELAVANCIN AGAINST STAPHYLOCOCCI AND ENTEROCOCCI BY MIC AND RESISTANCE SELECTION STUDIES. (PubMed)

nonsusceptible to daptomycin at the same concentration. All strains were susceptible to quinupristin-dalfopristin, while resistance was found to all other drugs tested. Telavancin demonstrated potent activity against all vancomycin-susceptible isolates as well as against heterogeneously VISA and VISA resistance phenotypes. In multistep resistance selection studies, telavancin yielded one stable mutant after 43 days in one MRSA strain out of the 10 MRSA strains tested with the MIC rising eightfold from 0.25

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2009 Antimicrobial Agents and Chemotherapy

157. Study of Temsirolimus, Erlotinib and Cisplatin in Solid Tumors

are primarily metabolized by CYP3A4. Patients CANNOT be receiving enzyme-inducing or enzyme inhibiting agents listed here: Inhibitors: Amiodarone, Amprenavir, Atazanavir, Chloramphenicol, Clarithromycin, Conivaptan, Cyclosporine, Darunavir, Dasatinib, Delavirdine, Diltiazem, Erythromycin, Fluconazole, Fluoxetine, Fluvoxamine, Fosamprenavir, Imatinib, Indinavir, Isoniazid, Itraconazole, Ketoconazole, Lapatinib, Miconazole, Nefazodone, Nelfinavir, Posaconazole, Ritonavir, Quinupristin, Saquinavir, Tamoxifen

2009 Clinical Trials

158. Identification, antimicrobial resistance and genotypic characterization of Enterococcus spp. isolated in Porto Alegre, Brazil (PubMed)

% to tetracycline, 24.6% to rifampicin, 30% to ciprofloxacin and 87.2% to quinupristin-dalfopristin. A total of 10.3% of the isolates proved to be HLAR to both gentamicin and streptomycin (HLR-ST/GE), with 23.6% resistant only to gentamicin (HLR-GE) and 37.4% only to streptomycin (HLR-ST). One predominant clonal group was found among E. faecalis HLR-GE/ST. The prevalence of resistance among beta-lactam antibiotics and glycopeptides was very low. However, in this study there was an increased number of HLR

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2009 Brazilian Journal of Microbiology

159. Intracellular activity of antibiotics in a model of human THP-1 macrophages infected by a Staphylococcus aureus Small Colony Variant isolated from a cystic fibrosis patient : 1. Pharmacodynamic evaluation and comparison with isogenic normal phenotype and (PubMed)

, rifampin, vancomycin, linezolid, quinupristin-dalfopristin, daptomycin, tigecycline, moxifloxacin, telavancin, and oritavancin have been examined in THP-1 macrophages infected by a stable thymidine-dependent SCV strain in comparison with normal-phenotype and revertant isogenic strains isolated from the same cystic fibrosis patient. The SCV strain grew slowly extracellularly and intracellularly (1- and 0.2-log CFU increase in 24 h, respectively). In confocal and electron microscopy, SCV and the normal (...) -phenotype bacteria remain confined in acid vacuoles. All antibiotics tested, except tigecycline, caused a net reduction in bacterial counts that was both time and concentration dependent. At an extracellular concentration corresponding to the maximum concentration in human serum (total drug), oritavancin caused a 2-log CFU reduction at 24 h; rifampin, moxifloxacin, and quinupristin-dalfopristin caused a similar reduction at 72 h; and all other antibiotics had only a static effect at 24 h and a 1-log CFU

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2009 Antimicrobial Agents and Chemotherapy

160. Intracellular activity of antibiotics in a model of human THP-1 macrophages infected by a Staphylococcus aureus Small Colony Variant isolated from a cystic fibrosis patient : 2. Study of antibiotic combinations. (PubMed)

) strain isolated from a cystic fibrosis patient and that the activity of quinupristin-dalfopristin, moxifloxacin, rifampin, and oritavancin remains limited (2- to 3-log CFU reduction) compared to their extracellular activity. Antibiotic combination is a well-known strategy to improve antibacterial activity, which was examined here against an intracellular SCV strain using combinations with either rifampin or oritavancin. Time-kill curve analysis using either concentrations that caused a static effect

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2009 Antimicrobial Agents and Chemotherapy

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