From the Research
For a urinary tract infection caused by Streptococcus mitis/oralis, vancomycin is the best antibiotic choice, as evidenced by a recent case study 1, which reported multidrug resistance to penicillin, ceftriaxone, cefepime, levofloxacin, ofloxacin, and tetracycline, but sensitivity to vancomycin. The recommended dosage for vancomycin is typically 1 gram every 12 hours for 5-7 days, but this may vary depending on the patient's renal function and other factors. It's essential to note that Streptococcus mitis/oralis is an unusual cause of UTIs, and its presence in urine may indicate sample contamination or an unusual infection pathway. Patients should complete the full course of antibiotics even if symptoms improve, drink plenty of water, and seek medical attention if symptoms worsen or don't improve within 48 hours. Urine culture and sensitivity testing is valuable to confirm the diagnosis and ensure the selected antibiotic is effective against the specific strain. Some studies suggest that amoxicillin or penicillin may be effective against Streptococcus mitis/oralis 2, 3, 4, but the most recent evidence suggests that vancomycin is a better option due to the risk of multidrug resistance 1. In any case, the choice of antibiotic should be guided by the results of urine culture and sensitivity testing to ensure the best possible outcome. Key considerations in the treatment of UTIs caused by Streptococcus mitis/oralis include:
- The use of vancomycin as a first-line antibiotic due to its effectiveness against multidrug-resistant strains 1
- The importance of completing the full course of antibiotics to ensure complete eradication of the infection
- The need for urine culture and sensitivity testing to guide antibiotic therapy and ensure the best possible outcome
- The potential for sample contamination or unusual infection pathways due to the unusual nature of Streptococcus mitis/oralis as a cause of UTIs.