From the Research
No, ertapenem does not cover Enterococcus faecium. Ertapenem is a carbapenem antibiotic that has poor activity against enterococci, including both E. faecalis and E. faecium [ 1 ]. E. faecium is particularly resistant to many antibiotics, including carbapenems like ertapenem. For infections caused by E. faecium, other antimicrobial agents should be considered, such as vancomycin for vancomycin-susceptible isolates or linezolid, daptomycin, or quinupristin-dalfopristin for vancomycin-resistant strains.
Key Points to Consider
- The lack of activity against enterococci is due to ertapenem's poor binding affinity for the penicillin-binding proteins in these organisms [ 1 ].
- This is an important consideration when selecting empiric therapy for infections that might involve enterococci, such as complicated intra-abdominal infections, urinary tract infections, or endocarditis, where alternative or additional antimicrobial coverage would be necessary.
- Ertapenem has a broad spectrum of activity against many Gram-negative and Gram-positive aerobic and anaerobic bacteria, but its use is limited by its lack of activity against certain nosocomial pathogens, including Pseudomonas aeruginosa, Acinetobacter species, methicillin-resistant staphylococci, and enterococci [ 2 ].
Clinical Implications
- Clinicians should be aware of the limitations of ertapenem's spectrum of activity and consider alternative antimicrobial agents when treating infections that may involve enterococci or other resistant organisms.
- The selection of empiric therapy should be guided by the suspected or confirmed pathogens involved in the infection, as well as the local epidemiology of antimicrobial resistance [ 3 ].