What is the first-line treatment for Aerococcus urinary tract infections?

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Last updated: June 3, 2025View editorial policy

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From the Research

The first-line treatment for Aerococcus urinary tract infections is typically nitrofurantoin, as it has been shown to achieve clinical and microbiological success in 71/76% of cases of A. urinae UTI, and 42/50% of cases of A. sanguinicola UTI 1.

Treatment Options

  • For uncomplicated cases, oral nitrofurantoin 100 mg twice daily is often sufficient.
  • In patients with severe infections or those with systemic symptoms, initial intravenous therapy with antibiotics such as ampicillin or penicillin G may be necessary before transitioning to oral antibiotics.
  • Aerococcus species are generally susceptible to beta-lactam antibiotics, but resistance to ciprofloxacin has been reported in some cases 2.

Important Considerations

  • It's essential to obtain urine cultures before starting treatment to confirm the diagnosis and check antibiotic susceptibility, as some strains may show resistance.
  • Patients should complete the full course of antibiotics even if symptoms resolve earlier to prevent recurrence.
  • Increased fluid intake is also recommended to help flush bacteria from the urinary tract.

Alternative Treatment Options

  • Pivmecillinam has been shown to be effective in patients with A. urinae cystitis, while ciprofloxacin may be used in patients with pyelonephritis 1.
  • Nitroxoline has been shown to have high activity against A. urinae, but low activity against A. sanguinicola, and may be considered as an alternative oral drug to treat A. urinae urinary tract infection 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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