Journal of Antimicrobial Chemotherapy (2001) 47, 639-645
© 2001 The British Society for Antimicrobial Chemotherapy
Successful administration of quinupristin/dalfopristin in the outpatient setting
a Department of Infectious Disease, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195; b The Springfield Clinic, Springfield, IL; c Bethesda Memorial Hospital, Boynton Beach, FL; d Aventis Pharmaceuticals, Bridgewater, NJ, USA; e Aventis Pharmaceuticals, Antony, France
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.
* Corresponding author. Tel: +1-216-444-6847; Fax: +1-216-444-1010; E-mail: rehms{at}ccf.org