E.faecalis treatment

[rxforlife2004]

I am studying for the board exam and this issue comes up...Say you're trying to cover VRE E.faecalis. So my option now are the big gun agents: Zyvoxx, Synercid, and Tygacil. Now the problem is Zyvoxx and Synercid are only good for VRE E. faecium. So those two are gone off the list. Tygacil isn't working either because this is VRE Enteroccoccus....So anyone has any idea how to treat such case? 😕 I am thinking about maybe using synergic Ampicillin + Aminoglycoside......'cuz there was one studying show benefits, even if it's VRE....Correct me if i am wrong...Thanks

 

[DrugDealer]

I like amp + aminoglycoside. What about daptomycin? And I vaguely remember discussing chloramphenicol as an option when we discussed VRE in class.

 

[ZpackSux]

For VRE Faecalis UTI, Nitrofurantoin.
For VRE but b-lactamase neg - Pen G or Amp... or Linezolid, 60% effective

tygacil, linezolid, and daptomycin should be effective generally.

Aminoglycoside provides synergism with Vanco.

Treat if it's an infection. If it's not an infection but rather a conlonization, then, it may not require treatment.

 

[38ctk]

I would go with Linezolid
it has fewer sideeffects than synercid (except the thrombocytopenia issue), it has a broader spectrum (which also covers VREF), and is more cost effective :O). AT least at my hospital