Therapeutic options for infections due to vancomycin-resistant enterococci.
BACKGROUND
Vancomycin-resistant enterococci (VRE) are an important cause of nosocomial infection occurring in critical care or immunocompromised patients.


OBJECTIVE
To provide updated information about therapeutic options for VRE infection.


METHODS
MEDLINE, EMBASE, and the Cochrane Library were searched to identify in vitro susceptibility data of VRE isolates, randomized and non-randomized controlled trials, case series, and cohort studies of VRE therapy published before 31 July 2008.


CONCLUSIONS
The updated in vitro susceptibility data for VRE show high resistance to ampicillin and aminoglycosides. Quinupristin-dalfopristin is limited by its lack of activity against vancomycin-resistant Enterococcus faealis and its musculoskeletal side effects. Emerging linezolid resistance has been reported to cause hospital spread and may be related to prolonged linezolid use. Quinupristin-dalfopristin resistance is usually linked to agricultural use of streptogramin. Nitrofurantoin and fosfomycin are alternatives in uncomplicated VRE urinary tract infection. Daptomycin and tigecycline have shown excellent potential for treating VRE infection.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Jiun-Ling
JL
Wang
Po-Ren
PR
Hsueh
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D018849:Controlled Clinical Trials as Topic / Q000379:methods; D016984:Enterococcus faecium / Q000187:drug effects* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D020713:Vancomycin Resistance / Q000187:drug effects / Q000502:physiology*
D000900:Anti-Bacterial Agents