title: Safety and efficacy of commonly used antimicrobial agents in the treatment of enterococcal infections: a review.
abstract: BACKGROUND
  Enterococci have become the second leading cause of nosocomial infections in the U.S, which are associated with higher morbidity, mortality, length of stay, and cost due to escalating resistance to several antimicrobial agents. With limited treatment options, the adverse events associated with the increasing use of available agents must be considered.
  
  
  METHODS
  Safety data about the most commonly used antimicrobial agents to treat enterococcal infections (ampicillin, vancomycin, linezolid, daptomycin, and tigecycline) derived from animal models, clinical trials and post-marketing surveillance are evaluated. However, most of these agents are not FDA approved and have been used for off-label indications in enterococcal infections.
  
  
  CONCLUSIONS
  The commonly used antimicrobials to treat enterococcal infections have unique safety profiles and side effects but are generally safe and tolerated in the short-term based on data from clinical trials and post-marketing surveillance. However, serious long-term adverse events may occur, and antibiotic selection should be individualized and based on source of infection, duration, potential drug-related toxicity, and drug-drug interactions to minimize side-effects. Implementing standard precautions and infection control measures, minimizing unnecessary antibiotic exposure, and optimizing treatment and duration with removal of source of infection are essential to prevent the spread of resistance and improve outcomes.
authors.affiliation: a Infectious Disease Department , Henry Ford Hospital , Detroit , MI , USA.
authors.forename: Geehan
authors.initials: G
authors.lastname: Suleyman
authors.affiliation: a Infectious Disease Department , Henry Ford Hospital , Detroit , MI , USA.
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Zervos
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004347:Drug Interactions; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D056687:Off-Label Use; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Ampicillin; daptomycin; enterococcal treatment; linezolid; safety; tigecycline; vancomycin