Successful Treatment of Vancomycin-Resistant Enterococcus faecium Bacteremia with Linezolid after Failure of Treatment with Synercid (Quinupristin/Dalfopristin)

Abstract

The emergence of vancomycin-resistant Enterococcus faecium (VRE) as an increasingly common cause of nosocomial infections has spurred renewed interest in the development of novel antimicrobial agents [1]. Quinupristin-dalfopristin (Synercid, Rhône-Poulenc Rorer, Paris) is a combination of 2 chemically distinct streptogramins, streptogramin A (dalfopristin) and streptogramin B (quinupristin), which act synergistically to inhibit bacterial protein synthesis [2]. Synercid has bactericidal activity against most drug-resistant staphylococci, streptococci, and pneumococci; appears to be bacteriostatic against E. faecium; and is not active against Enterococcus faecalis [2, 3].