From the Research
The recommended antibiotic therapy for Bacillus cereus infections is vancomycin, often used as the first-line treatment, sometimes combined with an aminoglycoside like gentamicin, due to its effectiveness against this pathogen as shown in recent studies 1. For gastrointestinal infections, which are typically self-limiting food poisoning syndromes, antibiotic therapy is generally not recommended as these infections resolve within 24 hours with supportive care only.
- For systemic or severe infections such as bacteremia, endophthalmitis, or CNS infections,
- vancomycin (15-20 mg/kg IV every 8-12 hours) is often the first-line treatment,
- sometimes combined with an aminoglycoside like gentamicin (5-7 mg/kg IV daily).
- Alternative options include
- clindamycin (600-900 mg IV every 8 hours),
- ciprofloxacin (400 mg IV every 12 hours),
- or linezolid (600 mg IV/oral every 12 hours). Treatment duration typically ranges from 7-14 days depending on infection severity and site. B. cereus produces beta-lactamases that confer resistance to penicillins and cephalosporins, making these antibiotics ineffective 2. Susceptibility testing is important as resistance patterns can vary, and surgical intervention may be necessary for localized infections such as abscesses or endophthalmitis in addition to antibiotic therapy 3. It's worth noting that while other studies have reported various treatment options, the most recent and highest quality study 1 supports the use of vancomycin as a first-line treatment. In addition, a case report of a patient with propionic acidemia who was successfully treated for B. cereus bacteremia also highlights the importance of appropriate antibiotic therapy 4. Another study on the susceptibility of B. cereus to different antimicrobials found that all isolates were susceptible to vancomycin, gentamicin, and other antibiotics, but resistance to some antibiotics like clindamycin was observed 3. A unique case of penile skin infection caused by B. cereus was also reported, which was successfully treated with fucidic acid ointment 5.