Enterococcus faecium: Difference between revisions

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'''''Enterococcus faecium''''' is a [[gram positive]] [[bacterium]] in the genus ''[[Enterococcus]]''. It can be a [[commensal]] (a non-harmful coexistence), in the human intestine, but it may also be a [[pathogen]] causing disease. Antibiotic resistant ''Enterococcus faecium'' is often referred to as 'VRE', [[Vancomycin-Resistant Enterococcus]].
'''''Enterococcus faecium''''' is a [[gram positive]] [[bacterium]] in the genus ''[[Enterococcus]]''. It can be a [[commensal]] (a non-harmful coexistence), in the human intestine, but it may also be a [[pathogen]] causing disease. Antibiotic resistant ''Enterococcus faecium'' is often referred to as 'VRE', [[Vancomycin-Resistant Enterococcus]].
===Antimicrobial regimen===
===Antimicrobial regimen===
* [[Enterococcus faecium]]
:* 1. '''Bacteremia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*'''1.Bacteremia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1.1 '''Ampicillin or penicillin susceptible'''
::*[[Ampicillin]] or [[Penicillin]] susceptible : [[Ampicillin]] 2 g IV q4-6h {{or}} ([[Ampicillin]] {{and}} [[Gentamicin]] 1 mg/kg q8h).
:::* Preferred regimen (1): [[Ampicillin]] 2 g IV q4-6h
::*[[Ampicillin]] resistant and [[vancomycin]] susceptible or [[Penicillin]] allergy : ([[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg q8h) {{or}} [[Linezolid]] 600 mg q12h {{or}} [[Daptomycin]] 6 mg/kg per day.
:::* Preferred regimen (2): [[Ampicillin]] 2 g IV q4-6h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
::*[[Ampicillin]] and [[Vancomycin]] resistant : [[Linezolid]] 600 mg q12h {{or}} [[Daptomycin]] 6 mg/kg IV per day
::* 1.2 '''Ampicillin resistant and vancomycin susceptible or penicillin allergy'''
:*'''2.Endocarditis'''  
:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
::*2.1.Endocarditis in Adults <ref name="Baddour-2005">{{Cite journal  | last1 = Baddour | first1 = LM. | last2 = Wilson | first2 = WR. | last3 = Bayer | first3 = AS. | last4 = Fowler | first4 = VG. | last5 = Bolger | first5 = AF. | last6 = Levison | first6 = ME. | last7 = Ferrieri | first7 = P. | last8 = Gerber | first8 = MA. | last9 = Tani | first9 = LY. | title = Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal = Circulation | volume = 111 | issue = 23 | pages = e394-434 | month = Jun | year = 2005 | doi = 10.1161/CIRCULATIONAHA.105.165564 | PMID = 15956145 }}</ref>
:::* Preferred regimen (2): [[Linezolid]] 600 mg IV q12h  
:::*Strains Susceptible to [[Penicillin]], [[Gentamicin]], and [[Vancomycin]]
:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg IV q24h.
::::*Preferred regimen : ([[Ampicillin|Ampicillin]] 12 g/day IV for 4–6weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 18–30 MU/day IV for 4–6weeks) {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 4–6 weeks
::* 1.3 '''Ampicillin and vancomycin resistant'''
::::*'''Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended '''
:::* Preferred regimen (1): [[Linezolid]] 600 mg IV q12h  
::::*Alternate regimen : [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6weeks
:::* Preferred regimen (2): [[Daptomycin]] 6 mg/kg IV q24h
:::*Strains Susceptible to [[Penicillin]], [[Streptomycin]], and [[Vancomycin]] and Resistant to [[Gentamicin]]
:* 2. '''Endocarditis'''<ref name="Baddour-2005">{{Cite journal  | last1 = Baddour | first1 = LM. | last2 = Wilson | first2 = WR. | last3 = Bayer | first3 = AS. | last4 = Fowler | first4 = VG. | last5 = Bolger | first5 = AF. | last6 = Levison | first6 = ME. | last7 = Ferrieri | first7 = P. | last8 = Gerber | first8 = MA. | last9 = Tani | first9 = LY. | title = Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal = Circulation | volume = 111 | issue = 23 | pages = e394-434 | month = Jun | year = 2005 | doi = 10.1161/CIRCULATIONAHA.105.165564 | PMID = 15956145 }}</ref><ref>{{Cite web | title =Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association| url =http://circ.ahajournals.org/content/111/23/e394.full.pdf+html}}</ref>
::::*Preferred regimen : ([[Ampicillin]] 12 g/day IV for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 24 MU/day IV for 4–6weeks){{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg/day IV/IM for 4–6weeks
::* 2.1 '''Endocarditis in adults'''  
::::*Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV 6weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg per 24 h IV/IM for 6weeks
:::* 2.1.1 '''Strains susceptible to penicillin, gentamicin, and vancomycin'''
:::*Strains Resistant to [[Penicillin]] and Susceptible to [[Aminoglycoside]] and [[Vancomycin]]
::::* Preferred regimen: ([[Ampicillin|Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 18–30 MU IV q24h for 4–6 weeks) {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 4–6 weeks
::::*β Lactamase–producing strain
::::* Alternative regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
::::*Preferred regimen : [[Ampicillin-sulbactam]] 12 g/day IV for 6weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM 6weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks  
::::*Alternate regimen : [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6weeks
::::*Intrinsic [[penicillin]] resistance : [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6weeks
:::*Strains Resistant to [[Penicillin]], [[Aminoglycoside]], and [[Vancomycin]]
::::*Preferred regimen : [[Linezolid]] 1200 mg/day IV/PO ≥8weeks {{or}} [[Quinupristin]]-[[Dalfopristin]]22.5 mg/kg/day IV ≥8weeks
::*2.2.Endocarditis in Pediatrics
:::*Strains Susceptible to [[Penicillin]], [[Gentamicin]], and [[Vancomycin]]
::::*Preferred regimen : ([[Ampicillin]] 300 mg/kg/day IV for 4–6 weeks {{or}} [[Penicillin]] 300,000U/kg/day IV for 4–6 weeks) {{and}} [[Gentamicin]] 3 mg/kg per 24 h IV/IM 4–6 weeks
::::*'''Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended '''
::::*Alternate regimen : [[Vancomycin]] 40 mg/kg/day IV for 6weeks {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM for 6weeks
:::*Strains Susceptible to [[Penicillin]], [[Streptomycin]], and [[Vancomycin]] and Resistant to [[Gentamicin]]
::::*Preferred regimen : ([[Ampicillin]] 300 mg/kg/day IV for 4–6 weeks {{or}} [[Penicillin]] 300,000 U/kg/day IV for 4–6 weeks) {{and}} [[Streptomycin]] 20–30 mg/kg/day IV/IM for 4–6 weeks
::::*Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 40 mg/kg/day IV for 6weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg/day IV/IM for 6weeks
:::*Strains Resistant to [[Penicillin]] and Susceptible to [[Aminoglycoside]] and [[Vancomycin]]
::::*β Lactamase–producing strain 
::::*Preferred regimen : [[Ampicillin-sulbactam]] 300 mg/kg/day IV for 6weeks {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM for 6weeks
::::*Alternate regimen : [[Vancomycin]] 40 mg/kg/day IV for 6weeks {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM for 6weeks
::::*Intrinsic penicillin resistance : [[Vancomycin]] 40 mg/kg/day IV {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM for 6weeks
:::*Strains Resistant to [[Penicillin]], [[Aminoglycoside]], and [[Vancomycin]]
::::*Preferred regimen : [[Linezolid]] 30 mg/kg/day IV/PO ≥ 8weeks {{or}} [[Quinupristin]]-[[Dalfopristin]]22.5 mg/kg/day IV ≥ 8weeks


:*'''3.Meningitis'''<ref name="pmid15494903">{{vcite2 journal |vauthors=Tunkel AR, Hartman BJ, Kaplan SL, et al. |title=Practice guidelines for the management of bacterial meningitis |journal=Clin. Infect. Dis. |volume=39 |issue=9 |pages=1267–84 |year=2004 |pmid=15494903 |doi=10.1086/425368 |url= |issn=}}</ref>   
::::* Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
::*[[Ampicillin]] susceptible
::::* Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
:::*Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::::* Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
::*[[Ampicillin]] resistant
:::* 2.1.2 '''Strains susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin'''
:::*Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::::* Preferred regimen: ([[Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 24 MU/day IV q24h for 4–6 weeks) {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 4–6 weeks
::*[[Ampicillin]] and [[vancomycin]] resistant
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks
:::*Preferred regimen: [[Linezolid]] 600 mg IV q12h
:::* 2.1.3 '''Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin'''
:*'''4.Urinary tract infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::::* 2.1.3.1 '''β Lactamase–producing strain'''
::*Preferred regimen : [[Nitrofurantoin]] 100 mg PO q6h for 5 days {{or}} [[Fosfomycin]] 3 g PO single dose {{or}} [[Amoxicillin]] 875 mg-1 g PO q12h for 5 days
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 12 g IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
:*'''5.Intra abdominal or Wound infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
::*[[Penicillin]] or [[Ampicillin]] are preferred agents, [[Vancomycin]] in setting of [[penicillin]] allergy or high-level [[penicillin]] resistance.
::::* 2.1.3.2 '''Intrinsic penicillin resistance'''
::*For complicated skin-skin structure and intra-abdominal infection : [[Tigecycline]] 100 mg IV single dose and 50 mg IV q12h
:::::* Preferred regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
:::* 2.1.4 '''Strains resistant to penicillin, aminoglycoside, and vancomycin''' 
::::* Preferred regimen (1): [[Linezolid]] 1200 mg IV/PO q24h ≥ 8 weeks
::::* Preferred regimen (2): [[Quinupristin]]-[[Dalfopristin]] 22.5 mg/kg IV q24h ≥ 8 weeks
::* 2.2 '''Endocarditis in pediatrics'''
:::* 2.2.1 '''Strains susceptible to penicillin, gentamicin, and vancomycin'''
::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3MU/kg IV q24h for 4–6 weeks) {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h 4–6 weeks
::::* Alternate regimen: [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
::::* Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
::::* Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
::::* Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
:::* 2.2.2 '''Strains Susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin'''
::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3MU/kg IV q24h for 4–6 weeks) {{and}} [[Streptomycin]] 20–30 mg/kg IV/IM q24h for 4–6 weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks
:::* 2.2.3 '''Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin'''
::::* 2.2.3.1 '''β Lactamase–producing strain'''
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 300 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
:::::* Alternate regimen: [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
::::* 2.2.3.2 '''Intrinsic penicillin resistance'''
::::* Preferred regimen: [[Vancomycin]] 40 mg/kg IV q24h {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
:::* 2.2.4 '''Strains resistant to penicillin, aminoglycoside, and vancomycin'''
::::* Preferred regimen (1): [[Linezolid]] 30 mg/kg IV/PO q24h ≥ 8 weeks
::::* Preferred regimen (2): [[Quinupristin]]-[[Dalfopristin]] 22.5 mg/kg IV q24h ≥ 8 weeks
 
:* 3. '''Meningitis'''<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903  }}</ref>   
::* 3.1 '''Ampicillin susceptible'''
:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::* 3.2 '''Ampicillin resistant'''
:::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::* 3.3 '''Ampicillin and vancomycin resistant'''
:::* Preferred regimen: [[Linezolid]] 600 mg IV q12h
 
:* 4. '''Urinary tract infections'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Nitrofurantoin]] 100 mg PO q6h for 5 days  
::* Preferred regimen (2): [[Fosfomycin]] 3 g PO single dose
::* Preferred regimen (3): [[Amoxicillin]] 875 mg to 1 g PO q12h for 5 days
 
:* 5. '''Intra abdominal or wound infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Penicillin]]  
::* Preferred regimen (2): [[Ampicillin]]
::* Alternative regimen (penicillin allergy or high-level penicillin resistance): [[Vancomycin]]
::* Alternative regimen (for complicated skin-skin structure and intra-abdominal infection): [[Tigecycline]] 100 mg IV single dose and 50 mg IV q12h
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{{bacteria-stub}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Revision as of 12:54, 31 July 2015

Enterococcus faecium is a gram positive bacterium in the genus Enterococcus. It can be a commensal (a non-harmful coexistence), in the human intestine, but it may also be a pathogen causing disease. Antibiotic resistant Enterococcus faecium is often referred to as 'VRE', Vancomycin-Resistant Enterococcus.

Antimicrobial regimen

  • 1. Bacteremia[1]
  • 1.1 Ampicillin or penicillin susceptible
  • 1.2 Ampicillin resistant and vancomycin susceptible or penicillin allergy
  • 1.3 Ampicillin and vancomycin resistant
  • Preferred regimen (1): Linezolid 600 mg IV q12h
  • Preferred regimen (2): Daptomycin 6 mg/kg IV q24h
  • 2.1 Endocarditis in adults
  • 2.1.1 Strains susceptible to penicillin, gentamicin, and vancomycin
  • Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
  • Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
  • Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
  • 2.1.2 Strains susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin
  • 2.1.3 Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin
  • 2.1.3.1 β Lactamase–producing strain
  • 2.1.3.2 Intrinsic penicillin resistance
  • 2.1.4 Strains resistant to penicillin, aminoglycoside, and vancomycin
  • 2.2 Endocarditis in pediatrics
  • 2.2.1 Strains susceptible to penicillin, gentamicin, and vancomycin
  • Preferred regimen: (Ampicillin 300 mg/kg IV q24h for 4–6 weeks OR Penicillin 0.3MU/kg IV q24h for 4–6 weeks) AND Gentamicin 3 mg/kg IV/IM q24h 4–6 weeks
  • Alternate regimen: Vancomycin 40 mg/kg IV q24h for 6 weeks AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
  • Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
  • Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
  • Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
  • 2.2.2 Strains Susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin
  • 2.2.3 Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin
  • 2.2.3.1 β Lactamase–producing strain
  • 2.2.3.2 Intrinsic penicillin resistance
  • Preferred regimen: Vancomycin 40 mg/kg IV q24h AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
  • 2.2.4 Strains resistant to penicillin, aminoglycoside, and vancomycin
  • 3. Meningitis[4]
  • 3.1 Ampicillin susceptible
  • 3.2 Ampicillin resistant
  • 3.3 Ampicillin and vancomycin resistant
  • 4. Urinary tract infections[5]
  • Preferred regimen (1): Nitrofurantoin 100 mg PO q6h for 5 days
  • Preferred regimen (2): Fosfomycin 3 g PO single dose
  • Preferred regimen (3): Amoxicillin 875 mg to 1 g PO q12h for 5 days
  • 5. Intra abdominal or wound infections [6]
  • Preferred regimen (1): Penicillin
  • Preferred regimen (2): Ampicillin
  • Alternative regimen (penicillin allergy or high-level penicillin resistance): Vancomycin
  • Alternative regimen (for complicated skin-skin structure and intra-abdominal infection): Tigecycline 100 mg IV single dose and 50 mg IV q12h

Template:Bacteria-stub Template:WikiDoc Sources

  1. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  2. ↑ Baddour, LM.; Wilson, WR.; Bayer, AS.; Fowler, VG.; Bolger, AF.; Levison, ME.; Ferrieri, P.; Gerber, MA.; Tani, LY. (2005). "Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America". Circulation. 111 (23): e394–434. doi:10.1161/CIRCULATIONAHA.105.165564. PMID 15956145. Unknown parameter |month= ignored (help)
  3. ↑ "Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association".
  4. ↑ Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM; et al. (2004). "Practice guidelines for the management of bacterial meningitis". Clin Infect Dis. 39 (9): 1267–84. doi:10.1086/425368. PMID 15494903.
  5. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  6. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
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