Optimizing antibiotic therapy of bacteremia and endocarditis due to staphylococci and enterococci: new insights and evidence from the literature

J Infect Chemother. 2015 May;21(5):330-9. doi: 10.1016/j.jiac.2015.02.012. Epub 2015 Mar 6.

Abstract

Gram-positive cocci are a well-recognised major cause of nosocomial infection worldwide. Bloodstream infections due to methicillin-resistant Staphylococcus aureus, methicillin-resistant coagulase-negative staphylococci, and multi-drug resistant enterococci are a cause of concern for physicians due to their related morbidity and mortality rates. Aim of this article is to review the current state of knowledge regarding the management of BSI caused by staphylococci and enterococci, including infective endocarditis, and to identify those factors that may help physicians to manage these infections appropriately. Moreover, we discuss the importance of an appropriate use of antimicrobial drugs, taking in consideration the in vitro activity, clinical efficacy data, pharmacokinetic/pharmacodynamic parameters, and potential side effects.

Keywords: Bacteremia; Coagulase-negative staphylococci; Enterococcus faecalis; Infective endocarditis; Methicillin-resistant Staphylococcus aureus; Vancomycin-resistant enterococci.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Coagulase / metabolism
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / microbiology
  • Enterococcus faecalis
  • Gram-Positive Bacterial Infections / complications
  • Gram-Positive Bacterial Infections / drug therapy*
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / enzymology
  • Microbial Sensitivity Tests
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / drug therapy*
  • Vancomycin-Resistant Enterococci

Substances

  • Anti-Bacterial Agents
  • Coagulase