Which drugs are used for monotherapy in enterococcal infections?

Updated: Jun 10, 2021
  • Author: Susan L Fraser, MD; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Ampicillin is the drug of choice for monotherapy of susceptible E faecalis infection. For most isolates, the MIC of ampicillin is 2- to 4-fold lower than that of penicillin. For rare strains that are resistant to ampicillin because of beta-lactamase production, ampicillin plus sulbactam may be used. Vancomycin should be used in patients with a penicillin allergy or infections with strains that have high-level penicillin resistance due to altered PBPs. Nitrofurantoin is effective in the treatment of enterococcal UTIs, including many caused by VRE strains. As more experience is gained with the use of linezolid, daptomycin, and tigecycline, these drugs may be used more commonly to treat VRE infections.


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