Comparative Pharmacology
Head-to-head clinical analysis: CHLORAMPHENICOL versus SYNERCID.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHLORAMPHENICOL versus SYNERCID.
CHLORAMPHENICOL vs SYNERCID
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing peptide bond formation.
Synercid is a combination of two streptogramin antibiotics, quinupristin and dalfopristin, which bind to the 50S bacterial ribosome and inhibit protein synthesis. Quinupristin binds to the 23S rRNA near the peptidyl transferase center, while dalfopristin binds to a nearby site and enhances quinupristin's binding. The synergistic effect results in irreversible inhibition of bacterial protein synthesis.
50-100 mg/kg/day IV divided every 6 hours (not to exceed 4 g/day); for susceptible severe infections, 12.5-25 mg/kg IV every 6 hours.
7.5 mg/kg IV every 8 hours, administered as a 60-minute infusion.
None Documented
None Documented
Clinical Note
moderateChloramphenicol + Fluconazole
"The metabolism of Fluconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ketoconazole
"The metabolism of Ketoconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ticlopidine
1.5-4.0 hours in adults; prolonged to 3-7 hours in neonates and up to 24 hours in severe hepatic impairment
The terminal elimination half-life is approximately 0.85 hours for dalfopristin and 1.3 hours for quinupristin; however, the active metabolite of quinupristin has a half-life of about 3.5 hours, supporting twice-daily dosing.
~90% renal (5-10% unchanged; remainder as inactive glucuronide), ~10% biliary/fecal
Primarily hepatic metabolism with biliary excretion; approximately 15% of the dalfopristin dose and 32% of the quinupristin dose are excreted unchanged in feces; renal excretion is minor (<5% for both components).
Category D/X
Category C
Antibiotic
Antibiotic
"The metabolism of Ticlopidine can be decreased when combined with Chloramphenicol."