pristinamycin

Action and Spectrum

Actions and Spectrum: 

Actions: 

• pristinamycin inhibits bacterial protein synthesis by binding to the bacterial ribosome, disrupting the formation of peptide bonds, and interfering with the growth and reproduction of susceptible bacteria. 
• It can exhibit both bacteriostatic (stops bacterial growth) and bactericidal (kills bacteria) effects depending on concentration and the specific bacteria involved. 

Spectrum: 

• pristinamycin primarily targets Gram-positive bacteria, including Staphylococcus, Streptococcus, and Enterococcus species. 
• It is effective against various infections caused by these Gram-positive bacteria, such as skin and soft tissue infections, respiratory tract infections, and bone and joint infections. 
• pristinamycin is not effective against most Gram-negative bacteria. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Hypersensitivity 

Gastric disturbances 

Black Box Warning

Black Box Warning: 

None 

Contraindication / Caution

Contraindication/Caution: 

Contraindications: 

• Hypersensitivity 

Cautions: 

• Liver dysfunction 
• Kidney dysfunction 
• Neuromuscular disorders 
• Clostridium difficile infection 
• Pregnancy  
• Breastfeeding 

Pregnancy / Lactation

Pregnancy consideration:  

Pregnancy Category: C 

Breastfeeding warnings:  

It is unknown whether the drug is excreted in the breast milk. 

Pregnancy category: 

Category A: Well-controlled and satisfactory studies show no risk to the fetus in the initial or later trimester. 

Category B: There was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: There was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.    

Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology:  

pristinamycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit in the bacterial ribosome. This disrupts the formation of peptide bonds, leading to the inhibition of bacterial growth and reproduction. 

pristinamycin can exhibit both bacteriostatic (stops bacterial growth) and bactericidal (kills bacteria) effects, depending on concentration and the targeted bacteria. 

Pharmacodynamics: 

pristinamycin is a combination drug consisting of pristinamycin IA and pristinamycin IB. These components work synergistically to inhibit bacterial protein synthesis. pristinamycin IA inhibits the early stages of protein synthesis by binding to the 50S ribosomal subunit in the bacterial ribosome. This disrupts the formation of peptide bonds and prevents the elongation of protein chains. 

Pharmacokinetics: 

Absorption: 

When taken orally, it is well-absorbed from the gastrointestinal tract. 

Distribution: 

pristinamycin is distributed throughout the body and can penetrate various tissues and compartments. 

Metabolism: 

pristinamycin is not significantly metabolized in the body. Its components, pristinamycin IA and pristinamycin IB are excreted mainly unchanged in the urine. 

Elimination and Excretion: 

pristinamycin is primarily eliminated via renal (kidney) excretion. 

The elimination half-life of pristinamycin can vary between individuals but is typically 30 to 60 minutes. 

Adminstartion

Administration: 

pristinamycin is available in tablet or capsule forms for oral administration. It is typically taken by mouth with water. 

The specific dosing regimen (dose and frequency) the healthcare provider prescribes depends on the type of infection, its severity, and individual patient factors. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: pristinamycin 

Why do we use pristinamycin? 

pristinamycin treats various bacterial infections, especially those caused by Gram-positive bacteria. It’s an alternative to beta-lactam antibiotics and is effective against skin and soft tissue infections, respiratory tract infections, bone and joint infections, and streptococcal infections.

pristinamycin may be used alone or in combination with other antibiotics to broaden its spectrum of activity. Its use is guided by factors such as the type of infection, bacterial susceptibility, and patient-specific considerations.