Pristinamycin-induced sideroblastic anaemia

Pristinamycin is an antibiotic composed of two streptogramin molecules used primarily in the treatment of Gram-positive bacterial infection.^1,2 Synergistic binding of these molecules to bacterial ribosomes inhibits protein synthesis, leading to bactericidal activity.³ Though generally well tolerated, gastrointestinal disturbance can occur and less commonly, severe reactions such as anaphylaxis, cutaneous drug eruptions or drug-induced haemolytic anaemia.^4–6 Sideroblastic anaemia, caused by pathological accumulation of iron leading to impaired haem biosynthesis from pristinamycin has not been previously documented. Herein we report the first case of probable pristinamycin-induced sideroblastic anaemia.