Two streptogramins are clinically important in human medicine in the treatment of last resort of vancomycin resistant enterococci, namely pristinamycin and the combination dalfopristin/quinupristin. ... The risk of reducing the effectiveness of human medicinal products such as erythromycin in particular and possibly lincomycin, clindamycin, pristinamycin and the new combination dalfopristin/quinupristin, which is due to be authorised as a human medicinal product shortly, as a result of selection of cross-resistance caused by tylosin phosphate and spiramycin, should be avoided. ... SCAN notes in its opinion that the virginiamycin-resistant enterococci and staphylococci isolated from poultry and pigs all had cross-resistance to pristinamycin used in human medicine or the combination dalfopristin/quinupristin, which is due to be authorised as a human medicinal product shortly. ... Two strains of E. faecium resistant to virginiamycin and pristinamycin, one isolated from a Dutch farmer and the other from his poultry, have the same genetic fingerprint.
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