Therapeutic options for vancomycin-resistant enterococcal bacteremia

Expert Rev Anti Infect Ther. 2015 Mar;13(3):363-77. doi: 10.1586/14787210.2015.1001839.

Abstract

Enterococcal infections are relatively common among hospitalized patients, likely because these organisms are commensals of human gastrointestinal and genitourinary tracts. With widespread usage of glycopeptides in both humans and livestock, vancomycin-resistant enterococci (VRE) quickly emerged. Bloodstream infections caused by these isolates are of significant concern with limited bactericidal options for treatment. Presently, daptomycin and linezolid serve as the mainstays of therapy, although resistance to both agents has been documented. Newer antimicrobials, specifically lipoglycopeptides and oxazolidinones, have been developed with in vitro activity against these organisms. However, no clinical data are available with their usage for VRE infections, let alone those in the bloodstream. This review focuses on the epidemiology, current and potential future therapeutic options for the treatment of VRE bacteremia.

Keywords: dalbavancin; daptomycin; linezolid; oritavancin; tedizolid; tigecycline; vancomycin-resistant enterococci.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy*
  • Clinical Trials as Topic
  • Drug Therapy, Combination
  • Glycopeptides
  • Gram-Positive Bacterial Infections / drug therapy*
  • Humans
  • Microbial Sensitivity Tests
  • Risk Factors
  • Vancomycin / therapeutic use*
  • Vancomycin Resistance*
  • Vancomycin-Resistant Enterococci / pathogenicity*
  • Virulence

Substances

  • Anti-Bacterial Agents
  • Glycopeptides
  • Vancomycin