From the Research
Gram-positive coccobacilli bacteremia is a serious infection that requires prompt treatment with intravenous antibiotics, and daptomycin is expected to be a better antimicrobial drug compared to vancomycin, as shown in a recent systematic review and meta-analysis 1.
Causes of Gram-Positive Coccobacilli Bacteremia
- Listeria monocytogenes
- Certain Corynebacterium species
- Some Lactobacillus species ### Treatment of Gram-Positive Coccobacilli Bacteremia
- Intravenous antibiotics such as ampicillin (2g IV every 4-6 hours) or vancomycin (15-20 mg/kg IV every 8-12 hours) for 10-14 days, depending on the specific organism identified and its antibiotic susceptibility
- For Listeria bacteremia, ampicillin plus gentamicin (1 mg/kg every 8 hours) is often recommended
- Daptomycin is a suitable alternative to vancomycin, especially in cases of vancomycin-resistant organisms 2 ### Diagnosis and Management
- Blood cultures are essential for diagnosis and should be obtained before starting antibiotics
- The source of infection should be identified and addressed, which may involve removing infected catheters or draining abscesses
- Patients require close monitoring for complications such as endocarditis, meningitis, or septic shock
- These infections can be particularly serious in immunocompromised patients, pregnant women, and the elderly, often requiring longer treatment courses and more aggressive management 3, 4