Pediatric Enterococcal Infection Medication

Updated: Jul 27, 2021
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Ampicillin (Omnipen, Polycillin, Principen)

Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria.

Gentamicin (Garamycin)

Inhibits protein synthesis by irreversibly binding to bacterial 30S and 50S ribosomes.

Vancomycin (Vancocin)

Inhibits cell wall synthesis by binding to carboxyl units on peptide subunits containing free D -alanyl-D-alanine. Potent antibiotic directed against gram-positive organisms and active against Enterococcus species. Useful in treatment of septicemia and skin structure infections.

Linezolid (Zyvox)

Inhibits formation of initiation complex in protein synthesis by preventing formation of tRNA-mRNA-70S and 30s subunit ternary complex. Binds to the 23S ribosomal RNA of the 50S subunit to prevent complex formation.

Bacteriostatic against enterococci and staphylococci and bactericidal against most strains of streptococci. Used as alternative in patients allergic to vancomycin and for treatment of VRE.

Quinupristin and dalfopristin (Synercid)

First of a class of antimicrobial agents known as streptogramins. Works by irreversibly binding to 50S and 70S ribosomes, which results in inhibition of protein synthesis. Used to treat serious or life-threatening bacteremia associated with vancomycin-resistant E faecium.

Penicillin G (Pfizerpen)

Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms.

Nitrofurantoin (Macrobid, Furadantin, Macrodantin)

Nitrofurantoin is an alternative to penicillins for uncomplicated UTIs. Synthetic nitrofuran that interferes with bacterial carbohydrate metabolism by inhibiting acetylcoenzyme A. Bacteriostatic at low concentrations (5-10 mcg/mL) and bactericidal at higher concentrations.

Dalbavancin (Dalvance)

Dalbavancin is a lipoglycopeptide antibiotic that prevents cross-linking by interfering with cell wall synthesis. It is indicated for acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible Gram-positive bacteria in pediatric patients from birth. It is effective against ABSSSI caused by Enterococcus faecalis (vancomycin-susceptible isolates).