What is the treatment for urinary tract infections (UTIs) caused by coagulase-negative staphylococci?

From the Guidelines

The treatment for urinary tract infections (UTIs) caused by coagulase-negative staphylococci should be guided by susceptibility testing, with first-line options including trimethoprim-sulfamethoxazole (TMP-SMX) or nitrofurantoin for uncomplicated cases, and fluoroquinolones or intravenous vancomycin for complicated or resistant cases. When considering the treatment of UTIs caused by coagulase-negative staphylococci, it's essential to note that the most recent and highest quality study 1 supports the use of short-course antibiotics for common infections, including UTIs. However, this study primarily focuses on the duration of treatment for complicated UTIs and pyelonephritis, rather than specifically addressing coagulase-negative staphylococci.

Key considerations for treating UTIs caused by coagulase-negative staphylococci include:

• The use of antibiotics based on susceptibility testing to ensure effective treatment
• First-line treatment options such as TMP-SMX (160/800 mg twice daily for 3-5 days for uncomplicated infections, or 7-14 days for complicated cases) or nitrofurantoin (100 mg four times daily for 5-7 days)
• Alternative options like fluoroquinolones (e.g., ciprofloxacin 250-500 mg twice daily for 3-7 days) for resistant strains
• The potential need for intravenous antibiotics (e.g., vancomycin 15-20 mg/kg every 8-12 hours) in severe cases or for patients with risk factors for complicated infections
• The importance of adequate hydration to help flush bacteria from the urinary tract
• Completing the full course of antibiotics to prevent recurrence and antibiotic resistance

It's also important to recognize that coagulase-negative staphylococci, particularly Staphylococcus saprophyticus, are a common cause of uncomplicated UTIs in young women, and these organisms can adhere to urinary tract epithelium, making appropriate antibiotic therapy crucial for complete eradication 1.

From the Research

Coagulase-Negative Staphylococci UTI Treatment

• The treatment for urinary tract infections (UTIs) caused by coagulase-negative staphylococci is not explicitly stated in the provided studies, but we can look at the general treatment options for UTIs caused by gram-positive bacteria.
• According to the study 2, daptomycin may be considered a promising antibacterial agent for the treatment of complicated UTI caused by gram-positive uropathogens, including coagulase-negative staphylococci.
• However, the other studies provided do not specifically mention coagulase-negative staphylococci as a cause of UTIs, and instead focus on the treatment of UTIs caused by other bacteria, such as Escherichia coli and Pseudomonas spp.
• The study 3 mentions that the recommended first-line empiric antibiotic therapy for acute uncomplicated bacterial cystitis in otherwise healthy adult nonpregnant females is a 5-day course of nitrofurantoin, a 3-g single dose of fosfomycin tromethamine, or a 5-day course of pivmecillinam, but it does not specifically address the treatment of UTIs caused by coagulase-negative staphylococci.
• The study 4 discusses the use of extended-release ciprofloxacin as a treatment option for UTIs, but it does not provide information on the effectiveness of this treatment against coagulase-negative staphylococci.
• The study 5 mentions the use of levofloxacin in the treatment of UTIs, but it does not specifically address the treatment of UTIs caused by coagulase-negative staphylococci.
• The study 6 evaluates the etiology of community-acquired lower recurrent UTI and bacterial antibiotic susceptibility, but it does not provide information on the treatment of UTIs caused by coagulase-negative staphylococci.

Treatment Options

• Based on the available information, it appears that daptomycin may be a potential treatment option for UTIs caused by coagulase-negative staphylococci, but further research is needed to confirm its effectiveness 2.
• Other treatment options for UTIs caused by gram-positive bacteria, such as vancomycin and linezolid, may also be considered, but their effectiveness against coagulase-negative staphylococci is not well established 2.