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| Pristinamycin IA | antibiotic |
| Pristinamycin IIA | antibiotic |
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| AHFS/Drugs.com | International Drug Names |
| MedlinePlus | a603007 |
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Pristinamycin (INN), also spelledpristinamycine, is anantibiotic used primarily in the treatment ofstaphylococcal infections, and to a lesser extentstreptococcal infections. It is astreptogramin group antibiotic, similar tovirginiamycin, derived from the bacteriumStreptomyces pristinaespiralis. It is marketed in Europe bySanofi-Aventis under the trade namePyostacine.
Pristinamycin is a mixture of two components that have a synergistic antibacterial action.Pristinamycin IIA is amacrolide, and results in pristinamycin's having a similar spectrum of action toerythromycin.Pristinamycin IA (streptogramin B) is adepsipeptide.[1] PI and PII are coproduced byS. pristinaespiralis in a ratio of 30:70. Each compound binds to the bacterial 50 S ribosomal subunit and inhibits the elongation process of the protein synthesis, thereby exhibiting only a moderate bacteriostatic activity. However, the combination of both substances acts synergistically and leads to a potent bactericidal activity that can reach up to 100 times that of the separate components.
The pristinamycin biosynthetic gene cluster is the largest antibiotic supercluster known so far, with a size of ~210 kb, wherein the PI and PII biosynthetic genes are not clustered individually but are scattered across the complete sequence region.[2] Furthermore, this biosynthetic gene region is interrupted by a cryptic type II PKS gene cluster.
Despite the macrolide component, it is effective against erythromycin-resistant staphylococci and streptococci.[3][4] It is active againstmethicillin-resistantStaphylococcus aureus (MRSA). Its usefulness for severe infections, however, may be limited by the lack of anintravenous formulation owing to its poor solubility.[5] Nevertheless, it is sometimes used as an alternative torifampicin+fusidic acid orlinezolid for the treatment of MRSA.
The lack of an intravenous formulation led to the development of the pristinamycin-derivativequinupristin/dalfopristin (i.e.,Synercid), which may be administered intravenously for more severe MRSA infections.