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Dalfopristin is a semi-synthetic streptogramin antibiotic, structurally related to ostreogyrcin A (virginiamycin M, pristinamycin IIA, streptogramin A). It is primarily used in combination with quinupristin (as the fixed-ratio product Synercid) for the treatment of severe or life-threatening infections caused by vancomycin-resistant Enterococcus faecium and complicated skin and skin structure infections due to methicillin-susceptible Staphylococcus aureus or Streptococcus pyogenes. Dalfopristin acts by inhibiting the early phase of protein synthesis at the bacterial ribosome (50S subunit), while quinupristin inhibits a later phase; together they have synergistic bactericidal activity against susceptible organisms. Dalfopristin is metabolized hepatically and excreted mainly via feces[1][5][7].
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