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Treatment of vancomycin-resistant Enterococcus faecium infections with quinupristin/dalfopristin.

Author(s): Linden PK, Moellering RC Jr, Wood CA, Rehm SJ, Flaherty J, Bompart F, Talbot GH, Synercid Emergency-Use Study Group

Affiliation(s): University of Pittsburgh Medical Center, Division of Critical Care Medicine, Pittsburgh, PA 15213, USA. lindenpk@anes.upmc.edu

Publication date & source: 2001-12-01, Clin Infect Dis., 33(11):1816-23. Epub 2001 Oct 19.

Publication type: Clinical Trial; Multicenter Study

Clinicians caring for patients with vancomycin-resistant Enterococcus faecium (VREF) infections face severe constraints in the selection of treatment. Quinupristin/dalfopristin (Synercid) is active in vitro against VREF, with a MIC(90) of 1.0 microg/mL. We investigated the clinical efficacy and safety of this agent in a multicenter, prospective, noncomparative, emergency-use study of 396 patients. Patients were included if they had signs and symptoms of active infection, including bacteremia of unknown origin, intra-abdominal infection, and skin and skin-structure infection, with no alternative antibiotic therapy available. The mean duration of treatment was 20 days (range, 4-40 days). The clinical response rate was 68.8% in the evaluable subset, and the overall response rate was 65.6%. The most common adverse events related to quinupristin/dalfopristin were arthralgias and myalgias. Related laboratory abnormalities were rare. In this severely ill patient population, quinupristin/dalfopristin was efficacious and demonstrated an acceptable safety profile in the treatment of VREF infection.

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