Enterococcal infections antibiotics

The role of Enterococcus as a pathogen is not clear. Enterococcal infection occurs more commonly in postoperative peritonitis, in the presence of specific risk factors indicating failure of the host defenses, or with the use of broad-spectrum antibiotics. 

Because of its potential toxicity, vancomycin is reserved for serious infections in which less toxic antibiotics are ineffective or not tolerated. Generally, vancomycin is administered intravenously because of poor intestinal absorption. It is the drug of choice for treating infections caused by methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae. Vancomycin has been used to treat enterococcal infections because of their resistance to the P-lactam antibiotics, but most enterococci are now also resistant to vancomycin. Oral administration of rancomycin is important for treatment of some gastrointestinal infections such as pseudomembranous colitis caused by C. difficile. 

Antimicrobial combination therapy is used frequently to treat serious infections. Combination therapy may be used prior to knowing the pathogen or antibiotic susceptibility for the treatment of infections in neutropenic patients and in patients with enterococcal endocarditis or bacteremia, sepsis, or pneumonia caused by P. aeruginosa. In these cases, it is important to know whether the combination will have beneficial (or detrimental) effects on the overall antibacterial activity of the regimen. For example, the combination may result in activity that is... 

In penicillin-allergic patients, vancomycin is an effective alternative for the treatment of endocarditis caused by viridans streptococci or, combined with an aminoglycoside, for enterococcal endocarditis. Vancomycin has become an important antibiotic in the management of known or suspected penicillin-resistant pneumococcal infections. 

A patient needs antibiotic treatment for native valve, culture-positive infective enterococcal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with (A) Amoxicillin/clavulanate Aztreonam... 

Vancomycin is an antibiotic of last resort for life-threatening enterococcal and staphylococcal infections, such as methicillin-resistant Staphylococcus aureus (MRSA). Numerous natural and semisynthetic glycopeptide analogs have since been synthesized [47]. However, the main emphasis was placed on the modification of the peripheral features of vancomycin, but the characteristic tricyclic... 

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