... even if cross-resistance to lincosamides and streptogramins has not been tested in Finland, macrolide resistance in enterococci is, according to the literature, often or mostly encoded for by different erm-genes also conferring resistance to lincosamides and streptogramin B; whereas there is a clinical problem in human medicine if the enterococci resistant to macrolides include also a major resistance to streptogramin B; ... whereas 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 ...
Synercid (Rhone-Poulenc Rorer), the first injectable streptogramin, is part of a new class of antibiotics designed to treat resistant gram-positive infections. Rhone-Poulenc Rorer recently filed a New Drug Application (NDA) for Synercid with the Food and Drug Administration (FDA).
Susceptibilities
Gram-positive cocci, including many that are resistant to b-lactams, macrolides, quinolones and glycopeptides, are susceptible to this new class of antibiotics. Streptogramins are comprised of two molecules, quinupristin and dalfopristin, which when combined create an agent that has the power to kill susceptible bacteria by inhibiting protein synthesis. Like most protein synthesis inhibitors, the individual components of streptogramins are bacteriostatic. Together, however, the two components exert a synergistic bactericidal effect.
