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Table 1. Treatment Considerations for Enterococcal Infections.

Table 1. Treatment Considerations for Enterococcal Infections.

Critical Illness/Sepsis

Endovascular Infection (eg, Infectious Endocarditis)

Central Nervous System Infection

Bone/Joint Infection

Serious Organ Infection (eg, Intra-abdominal or Kidney)

Uncomplicated Skin Infections

Bladder Infections

Penicillin-Susceptible Enterococci

Ampicillin 2 g IV q4h plus gentamicin 1 mg/kg IBW q8h

Penicillin 18-30 MU daily via continuous infusion or in divided doses plus gentamicin 1 mg/kg IBW q8h

Ampicillin 2 g IV q4h plus ceftriaxone 2 g IV q12h

[Ampicillin plus imipenem-cilastatin]

Ampicillin 2 g IV q4h for 4-6 weeks plus gentamicin 1 mg/kg IBW q8h for 2-6 weeks (or streptomycin 7.5 mg/kg IBW IV or IM]

Penicillin 18-30 MU daily via continuous infusion or in divided doses for 4-6 weeks plus gentamicin 1 mg/kg IBW q8h for 2-6 weeks [or streptomycin 7.5 mg/kg IBW IV or IM]

Ampicillin 2 gm IV q4h plus ceftriaxone 2 g IV q12h for 6 weeks

[Ampicillin plus imipenem-cilastatin for 6 weeks]

Ampicillin 2 g IV q4h plus gentamicin 1 mg/kg IBW q8h for 2-3 weeks

Penicillin 18-30 MU daily via continuous infusion or in divided doses for 4-6 weeks plus gentamicin 1 mg/kg IBW q8h for 2-3 weeks

Ampicillin 2 g IV q4h plus ceftriaxone 2 g IV q12h for 2-3 weeks

[Ampicillin plus imipenem-cilastatin for 2-3 weeks]

Penicillin G 20-24 MU IV q24h in continuous dosing or divided q4h for 4-6 weeks

Ampicillin 12 g IV q24h continuously or in 6 divided doses for 4-6 weeks

(For both regimens above, synergistic aminoglycoside is optional)

Penicillin G 20-24 MU IV q24h in continuous dosing or divided q4h

Ampicillin 12 g IV q24h continuously or in 6 divided doses

(For both regimens above, synergistic aminoglycoside is optional)

Ampicillin 8 g IV daily in divided doses

Penicillin G 12 MU IV divided q4-6h

Amoxicillin (or IV ampicillin)

(Other options may include oral doxycycline, linezolid, fosfomycin or chloramphenicol)

Penicillin-Resistant Enterococci or Patient Unable to Tolerate Beta-lactams

Vancomycin 15 mg/kg q12h plus either gentamicin 1 mg/kg/8h IV or IM or streptomycin 7.5 mg/kg IV or IM every 12 hours

Vancomycin 15 mg/kg q12h plus either gentamicin 1 mg/kg IV or IM q8h or streptomycin 7.5 mg/kg IV or IM q12h for 6 weeks

Vancomycin 15 mg/kg IV q12h for 4-6 weeks

(Addition of aminoglycoside is optional)

Vancomycin 15 mg/kg IV q12h

(Addition of aminoglycoside is optional)

Vancomycin 15 mg/kg IV q12h

(Addition of aminoglycoside is optional)

Nitrofurantoin

Doxycycline

Linezolid

Chloramphenicol

VRE

Linezolid 600 mg IV or PO q12h

Daptomycin 10-12 mg/kg once daily

Linezolid 600 mg IV or PO q12h for a minimum of 6 weeks

Daptomycin 10-12 mg/kg once daily for minimum of 6 weeks

Linezolid 600 mg IV or PO q12h for 2-3 weeks

Linezolid 600 mg IV or PO q12h for 4-6 weeks

Daptomycin 6 mg/kg once daily for 4-6 weeks

Linezolid 600 mg IV or PO q12h

Daptomycin 6 mg/kg once daily

Linezolid 600 mg IV or PO q12h

Daptomycin 4-6 mg/kg once daily

Nitrofurantoin

Doxycycline

Linezolid

Daptomycin

Chloramphenicol

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Author

Susan L Fraser, MD Infectious Diseases Physician, Providence St Peter Hospital; Associate Professor of Medicine, University of Washington School of Medicine; Infectious Diseases Staff, VA Puget Sound

Susan L Fraser, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, HIV Medicine Association, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Curtis J Donskey, MD Chairman of Infection Control, Instructor, Department of Internal Medicine, Section of Infectious Diseases, Stokes Cleveland VA Medical Center, Case Western Reserve University

Curtis J Donskey, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Robert A Salata, MD, FACP, FIDSA STERIS Chair of Excellence in Medicine, Professor and Chairman, Department of Medicine, Case Western Reserve University School of Medicine; Physician-in-Chief, Master Clinician in Infectious Diseases, University Hospitals Cleveland Medical Center

Robert A Salata, MD, FACP, FIDSA is a member of the following medical societies: American Association of Immunologists, American Federation for Medical Research, American Medical Association, Central Society for Clinical and Translational Research, Infectious Diseases Society of America, Ohio State Medical Association, Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

John L Brusch, MD, FACP Corresponding Faculty Member, Harvard Medical School

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

David Hall Shepp, MD Program Director, Fellowship in Infectious Diseases, Department of Medicine, North Shore University Hospital; Associate Professor, New York University School of Medicine

David Hall Shepp, MD is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Received salary from Gilead Sciences for management position.

Acknowledgements

Julia Lim, MD Associate Program Director, Internal Medicine Residency Program, Tripler Army Medical Center

Disclosure: Nothing to disclose.

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