From the Guidelines
Yes, Staphylococcus lugdunensis is generally susceptible to cefepime. Cefepime is a fourth-generation cephalosporin that has good activity against this coagulase-negative staphylococcal species. S. lugdunensis is typically more susceptible to beta-lactam antibiotics than other coagulase-negative staphylococci, showing a susceptibility profile more similar to Staphylococcus aureus.
Key Points to Consider
- According to the study published in Circulation 1, S. lugdunensis is uniformly susceptible in vitro to most antibiotics, which supports its susceptibility to cefepime.
- The European Heart Journal study 1 also notes that S. lugdunensis is always methicillin susceptible, further indicating its likelihood of being susceptible to cefepime.
- When treating S. lugdunensis infections, cefepime can be used at standard dosing (typically 1-2g IV every 8-12 hours in adults with normal renal function, adjusted for renal impairment).
- However, it's crucial to perform antimicrobial susceptibility testing to confirm sensitivity before definitive therapy, as methicillin-resistant strains, although less common, can occur.
- If methicillin resistance is detected, alternative agents such as vancomycin, daptomycin, or linezolid would be more appropriate choices than cefepime.
From the Research
Susceptibility of Staphylococcus lugdunensis to Cefepime
- The provided studies do not directly address the susceptibility of Staphylococcus lugdunensis to cefepime 2, 3, 4, 5, 6.
- However, study 2 mentions that Staphylococcus lugdunensis remains susceptible to most antibiotics, but it does not specifically mention cefepime.
- Study 3 discusses the use of cefepime in the management of hospitalized patients with pneumonia, but it does not provide information on its effectiveness against Staphylococcus lugdunensis.
- Study 4 reports that coagulase-negative staphylococci, including Staphylococcus lugdunensis, are sensitive to cefotaxime, but it does not provide information on cefepime.
- Study 5 investigates the pharmacodynamics of cefepime against methicillin-resistant Staphylococcus aureus, but it does not address Staphylococcus lugdunensis.
- Study 6 reports on skin and soft tissue infections caused by Staphylococcus lugdunensis, but it does not provide information on the susceptibility of the organism to cefepime.
Antibiotic Susceptibility of Staphylococcus lugdunensis
- Staphylococcus lugdunensis is generally susceptible to most antibiotics, including penicillin G, oxacillin, and other antibiotics tested in study 2.
- However, the resistance to penicillin varies widely, and methicillin resistance is still rare 2.
- Study 6 reports that all isolates of Staphylococcus lugdunensis were susceptible to most of the antibiotics tested, including oxacillin.