From the Research
The treatment for Aerococcus urinae infections should involve antibiotics, with penicillin or ampicillin being the first-line choices, as supported by the most recent study 1. When considering the treatment options for Aerococcus urinae infections, it's essential to prioritize the most recent and highest quality study available. The 2023 study 1 provides valuable insights into the susceptibility of Aerococcus urinae to standard antibiotics and nitroxoline.
- The study found that Aerococcus urinae isolates were highly susceptible to benzylpenicillin, ampicillin, meropenem, rifampicin, nitrofurantoin, and vancomycin, with 100% susceptibility to these antibiotics.
- Resistance was only documented against ciprofloxacin, with 10.9% of isolates showing resistance.
- Nitroxoline, an approved antimicrobial for UTI, demonstrated high activity against clinical A. urinae isolates, with low MICs (MIC50/90 1/2 mg/L). For uncomplicated urinary tract infections, amoxicillin 500 mg three times daily for 7-10 days is often effective, as it is a penicillin derivative and Aerococcus urinae is generally susceptible to penicillins due to the lack of beta-lactamase production 2, 3, 4. In more severe cases, such as bacteremia or endocarditis, intravenous penicillin G 2-4 million units every 4 hours or ampicillin 2 g every 4-6 hours for 4-6 weeks is recommended, often combined with an aminoglycoside like gentamicin for the first 2 weeks 5, 3, 4. For patients with penicillin allergies, vancomycin or ceftriaxone can be used as alternatives, as they have shown effectiveness against Aerococcus urinae infections 3, 4. It's crucial to perform susceptibility testing when possible to guide therapy, as resistance patterns can vary 2, 3, 4, 1. Patients with recurrent infections may require longer treatment courses or investigation for underlying urological abnormalities that might be predisposing them to infection 2, 4.