Vancomycin streptococcal

Streptococcal Vancomycin is effective alone or in combination with an aminoglycoside for endocarditis caused by S. virldans or S. bovis. It is only effective in combination with an aminoglycoside for endocarditis caused by enterococci (eg, S. faecal Is). 

After culture and sensitivity results are obtained, antibiotic therapy should be adjusted appropriately (Fig. 45-5). If the patient does not show signs of clinical improvement within 72 hours after antibiotic treatment is initiated, the culture should be repeated and the patient re-evaluated. For streptococcal or enterococcal peritonitis, IP ampicillin (125 mg/L in each exchange) is the preferred treatment. For Enterococcus, the addition of an aminoglycoside, depending on sensitivities, may be warranted for synergy. In addition, if the Enterococcus is resistant to both ampicillin and vancomycin, linezolid or quinupristin/dalfopristin are recommended. However, quinupristin/ dalfopristin is not effective against E.faecalis. 

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