Skip to Main Content

Key Features

  • Two species—Enterococcus faecalis and Enterococcus faecium— are responsible for most human enterococcal infections

Clinical Findings

  • Wound infections

  • Urinary tract infection

  • Bacteremia

  • Endocarditis

  • Meningitis

Diagnosis

  • Cultures of blood, affected fluids, or tissue

Treatment

  • Most enterococcal infections can be treated with

    • Penicillin, 3 million units every 4 hours intravenously

    • Ampicillin (which is slightly more active than penicillin in vitro), 2 g every 6 hours intravenously

    • Vancomycin, 1 g every 12 hours intravenously

  • Add gentamicin, 1 mg/kg every 8 hours intravenously for a duration of 2–3 weeks, to above regimens to achieve bactericidal activity required to cure

    • Endocarditis

    • Meningitis

  • Quinupristin/dalfopristin and linezolid are FDA approved for treatment of infections caused by vancomycin-resistant strains of enterococci (VRE)

  • Daptomycin, tigecycline, tedizolid, and oritavancin are not FDA approved for the treatment for VRE, although they are frequently active in vitro

  • Quinupristin/dalfopristin

    • Not active against strains of E faecalis

    • Should be used only for infections caused by E faecium

    • Dose is 7.5 mg/kg every 8–12 hours intravenously

  • Linezolid

    • An oxazolidinone

    • Active against both E faecalis and E faecium

    • Dose is 600 mg twice daily (both intravenous and oral formulations are available)

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.