title: Successful administration of quinupristin/dalfopristin in the outpatient setting.
abstract: Intravenous administration of quinupristin/dalfopristin outside the hospital setting has not been reported previously. We describe 37 outpatients receiving quinupristin/dalfopristin iv for infections including osteomyelitis, bacteraemia, abscesses and cellulitis. The most frequent aetiological pathogens found were Enterococcus faecium, Staphylococcus aureus and coagulase-negative staphylococci. Patients received an average of 9 days therapy as inpatients and 22 days as outpatients. Quinupristin/dalfopristin was administered using various access devices, most commonly peripherally inserted central catheters and tunnelled central catheters. The bacteriological and clinical success rates were both 89.2%. Five patients were readmitted to hospital; one patient developed catheter-related bacteraemia. The most frequently reported non-venous adverse events were nausea (18.9% of patients), myalgia (18.9%) and arthralgia (13.5%). Sixteen patients experienced venous access-related events, most commonly infusion pain, oedema and phlebitis. In this group of patients, for those who had difficult-to-treat infections, intravenous quinupristin/dalfopristin therapy was generally effective and safe outside the hospital setting.
authors.affiliation: Department of Infectious Disease, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. rehms@ccf.org
authors.forename: S J
authors.initials: SJ
authors.lastname: Rehm
authors.forename: D R
authors.initials: DR
authors.lastname: Graham
authors.forename: L
authors.initials: L
authors.lastname: Srinath
authors.forename: P
authors.initials: P
authors.lastname: Prokocimer
authors.forename: M P
authors.initials: MP
authors.lastname: Richard
authors.forename: G H
authors.initials: GH
authors.lastname: Talbot
mesh_terms: D000038:Abscess / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D016470:Bacteremia / Q000188:drug therapy; D004359:Drug Therapy, Combination / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy*; D016896:Treatment Outcome; D014769:Virginiamycin / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014769:Virginiamycin; C062940:quinupristin-dalfopristin