Pristinamycin

Pristinamycin (INN), also spelled pristinamycine, is an antibiotic used primarily in the treatment of staphylococcal infections, and to a lesser extent streptococcal infections. It is a streptogramin group antibiotic, similar to virginiamycin, derived from the bacterium Streptomyces pristina spiralis. It is marketed in Europe by Sanofi-Aventis under the trade name Pyostacine.

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Pristinamycin is a mixture of two components that have a synergistic antibacterial action. Pristinamycin I is a macrolide, and results in pristinamycin having a similar spectrum of action to erythromycin. Pristinamycin II is a depsipeptide.^[1]

Clinical use

Despite the macrolide component, it is effective against erythromycin-resistant staphylococci and strepcococci.^[2][3] Importantly, it is active against methicillin-resistant Staphylococcus aureus (MRSA). Its usefulness for severe infections, however, may be limited by the lack of an intravenous formulation owing to its poor solubility.^[4] Nevertheless it is sometimes used as an alternative to rifampicin+fusidic acid or linezolid for the treatment of MRSA.

The lack of an intravenous formulation led to the development of the pristinamycin-derivative quinupristin/dalfopristin, which may be administered intravenously for more severe MRSA infections.

See also

• Methicillin-resistant Staphylococcus aureus (MRSA)
• Quinupristin/dalfopristin