From the Research
The recommended treatment for Micrococcemia typically involves antibiotics such as vancomycin, penicillin, or clindamycin, with vancomycin being the first-line treatment for severe infections. For severe infections, intravenous vancomycin at 15-20 mg/kg every 8-12 hours (adjusted based on renal function) is often the first-line treatment, with therapy usually lasting 10-14 days depending on clinical response 1. Alternatives include penicillin G (2-4 million units every 4-6 hours) or clindamycin (600-900 mg every 8 hours).
Some key points to consider in the treatment of Micrococcemia include:
- Antibiotic susceptibility testing should guide therapy as resistance patterns can vary 2
- Micrococcus infections are relatively uncommon but may occur in immunocompromised patients or those with indwelling medical devices
- These gram-positive cocci were previously considered non-pathogenic skin commensals but are now recognized as opportunistic pathogens
- Source control is essential, so any infected catheters or devices should be removed when possible
- Supportive care and monitoring for complications are important components of management
- Treatment duration may be extended in cases involving prosthetic devices or in immunocompromised patients
It's also important to note that the choice of empiric therapy has become increasingly difficult because of the increasing incidence of antibiotic-resistant bacteria 2, and that initial empirical therapy with broad-spectrum antimicrobials attempts to address this dilemma by "getting it right up front" 3. However, the most recent and highest quality study on the treatment of vancomycin-resistant enterococcal bacteremia suggests that linezolid may be a better option than daptomycin in terms of mortality rates 4.
In terms of pharmacokinetic properties, vancomycin, linezolid, tigecycline, and daptomycin have different characteristics that should be considered when choosing an antibiotic regimen 1. Overall, the treatment of Micrococcemia requires careful consideration of the patient's individual needs and the potential risks and benefits of different antibiotic regimens.