Gram-positive bacteria staphylococci

In the 1-carbacephems (Fig. 5.5G), the sulphur in the six-membered dihydrothiazine ring ofthe cephalosporins (based on the cephem structure, see Fig. 5.4) is replaced by carbon. Loracarbef (Fig. 5.5U) is a new oral carbacephem which is highly active against Gram-positive bacteria, including staphylococci. 

Employed as a sodium salt, fusidic acid (Fig. 5.14B) is achve against many types of Gram-positive bacteria, especially staphylococci, although streptococci are relatively resistant. It is employed in the treatment of staphylococcal infections, including strains resistant to other antibiotics. However, bacterial resistance may occur in vitro and in vivo. 

In healthy individuals URT flora multiplies in gastric aspirate during treatment with antisecretory compounds and in particular proton pump inhibitors [34, 40, 44], This concerns viridans streptococci, coagulase-negative staphylococci, Haemophilus sp., diphtheroids, Moraxella sp., lactobacilli, and other streptococci, most of which are Gram-positive bacteria. With dedicated measures anaerobic species of oral origin are also recovered [66]. 

Initial therapy with trimethoprim-sulfamethoxazole appears to be effective for CA-MRSA and should be considered in geographic areas in which CA-MRSA are commonly encountered. Alternative agents for documented infections with resistant gram-positive bacteria such as methicil-lin-resistant staphylococci and vancomycin-resistant enterococci include linezolid, quinupristin/dalfopristin, daptomycin, and tigecycline. 

Vancomycin is an antibiotic produced by Streptococcus orientalis and Amycolatopsis orientalis. With the single exception of flavobacterium, it is active only against gram-positive bacteria, particularly staphylococci. Vancomycin is a glycopeptide of molecular weight 1500. It is water soluble and quite stable. 

Thiazole cephalosporin LB 11058, 434, demonstrated a broad antibacterial spectrum and was highly active against Gram-positive bacteria, particularly against multidrug-resistant staphylococci and streptococci <2004AAC53>. 

Second-generation cephalosporins are no more active against Gram-positive bacteria and may be less active against staphylococci than the first-generation drugs but have greater activity... 

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