Experience with quinupristin/dalfopristin in treating infections with vancomycin-resistant Enterococcus faecium in children.

Abstract

BACKGROUND:

The emergence and spread of vancomycin-resistant Enterococcus faecium (VREF) has presented serious therapeutic difficulties because of the lack of reliably active antibiotics. Quinupristin/dalfopristin is a new injectable streptogramin antibiotic that is active against most strains of VREF. Experience with this agent in adults with VREF infections is well-documented; however, there are few reports of its use in children. We report on eight children with VREF infections who received quinupristin/dalfopristin under a compassionate use protocol.

METHODS:

Quinupristin/dalfopristin was administered according to the manufacturer's recommendations. Clinical and laboratory data were recorded for each patient.

RESULTS:

The infections treated comprised six cases of bacteremia and two of peritonitis. All patients had serious underlying conditions. Seven patients recovered fully. One patient died, having experienced a relapse of his infection after quinupristin/dalfopristin was discontinued. None of the patients experienced side effects or other adverse events.

CONCLUSION:

Quinupristin/dalfopristin was well-tolerated and generally effective in children with infections caused by VREF. There is increasing evidence that it may be more effective than other currently available antibiotics in some such patients.

• Authors: J W Gray, P J Darbyshire, S V Beath, D Kelly, J R Mann
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 19 Issue 3 Pg. 234-8 (Mar 2000) ISSN: 0891-3668 [Print] United States
• PMID: 10749466 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Virginiamycin
• quinupristin
• dalfopristin

Topics

• Adolescent
• Anti-Bacterial Agents (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Drug Therapy, Combination (adverse effects, therapeutic use)
• Enterococcus faecium (isolation & purification)
• Female
• Gram-Positive Bacterial Infections (drug therapy, microbiology, mortality)
• Humans
• Infant
• Male
• Treatment Outcome
• Vancomycin Resistance
• Virginiamycin (adverse effects, analogs & derivatives, therapeutic use)