What is the best antibiotic to treat a urinary tract infection (UTI) with a urine culture positive for Aerococcus urinae?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 18, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

Nitrofurantoin is the best antibiotic for treating a urinary tract infection caused by Aerococcus urinae, as it achieves clinical and microbiological success in 71/76% of cases, according to a prospective observational study 1. When considering treatment options for Aerococcus urinae urinary tract infections, it's essential to prioritize antibiotics that have demonstrated efficacy against this specific pathogen.

  • Nitrofurantoin is a valid option for the treatment of cystitis caused by A. urinae, as shown in a study published in The Journal of Infection 1.
  • The study found that nitrofurantoin achieved clinical and microbiological success in 71/76% of cases of A. urinae UTI, making it a reliable choice for outpatient treatment.
  • In cases of penicillin allergy or other contraindications, alternative antibiotics such as pivmecillinam or ciprofloxacin may be considered, but their effectiveness may vary depending on the specific circumstances of the infection.
  • It's crucial to note that Aerococcus urinae can cause complicated UTIs and occasionally more serious infections like bacteremia or endocarditis, especially in elderly patients or those with underlying urological conditions, highlighting the importance of prompt and appropriate antibiotic treatment 2, 3.
  • Recent studies have also investigated the susceptibility of Aerococcus urinae to various antibiotics, including nitroxoline, which has shown high activity against A. urinae isolates 4.
  • However, the most recent and highest-quality study 1 supports the use of nitrofurantoin as a first-line treatment option for A. urinae UTIs, making it the recommended choice for clinicians.

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.