What are the effective antibiotics against Escherichia coli (E. coli) and Cutibacterium (formerly known as Propionibacterium) infections?

From the Guidelines

For treating infections caused by E. coli, I recommend using fluoroquinolones like ciprofloxacin (500mg twice daily for 7-14 days) or trimethoprim-sulfamethoxazole (160/800mg twice daily for 7-14 days) as first-line options, as supported by the American College of Physicians guidelines 1. For Cutibacterium acnes infections, which commonly cause acne and some surgical site infections, doxycycline (100mg twice daily) or minocycline (100mg twice daily) for 7-14 days are effective options, as they have been shown to be effective against Cutibacterium acnes in various studies 1. It's essential to note that E. coli increasingly shows resistance to many antibiotics, particularly fluoroquinolones and ampicillin, while Cutibacterium tends to be susceptible to many antibiotics but grows slowly, sometimes requiring longer treatment courses. Some key points to consider when treating these infections include:

• Treatment duration varies based on infection severity, with skin and soft tissue infections typically requiring 7-10 days and more invasive infections needing 14 days or longer.
• Completing the full course of antibiotics is crucial, even if symptoms improve, to prevent resistance development.
• For more severe Cutibacterium infections, clindamycin (300-450mg four times daily) may be used, but its effectiveness and potential side effects should be carefully considered 1.
• The increasing prevalence of antibiotic resistance, particularly among E. coli and other Gram-negative bacteria, highlights the need for judicious antibiotic use and careful selection of empirical therapy 1.

From the FDA Drug Label

Piperacillin and Tazobactam for Injection is indicated in adults and pediatric patients (2 months of age and older) for the treatment of appendicitis (complicated by rupture or abscess) and peritonitis caused by beta-lactamase producing isolates of Escherichia coli Piperacillin and Tazobactam for Injection is indicated in adults for the treatment of postpartum endometritis or pelvic inflammatory disease caused by beta-lactamase producing isolates of Escherichia coli Clindamycin is active in vitro against most isolates of Propionibacterium acnes;

The effective antibiotics against Escherichia coli (E. coli) infections are:

• Piperacillin-tazobactam (IV) 2 The effective antibiotics against Cutibacterium (formerly known as Propionibacterium) infections are:
• Clindamycin (TOP) 3

From the Research

Effective Antibiotics Against E. coli Infections

• Fosfomycin/minocycline (FOM/MINO) or rifampicin/sulfamethoxazole-trimethoprim (RFP/ST) combinations are effective in treating mild cases of urinary tract infections (UTIs) caused by ESBL-producing E. coli 4
• Meropenem (MEPM) is effective in treating severe cases of UTIs caused by ESBL-producing E. coli 4
• Carbapenems are effective against UTI isolates of E. coli, including ESBL isolates showing cross-resistance across oral agents 5
• Piperacillin-tazobactam (TZP) may be a treatment option for non-severe cases of ESBL-producing E. coli bacteremia in areas with low frequency of OXA-1 co-production 6

Effective Antibiotics Against Cutibacterium Infections

• There are no research papers provided to assist in answering this question

Resistance Patterns

• ESBL-producing E. coli show co-resistance to many oral agents, including fluoroquinolones and trimethoprim-sulfamethoxazole 5
• The use of trimethoprim-sulfamethoxazole (TMP-SMX) should be avoided as first-line therapy for UTI in patients who have recurrent UTIs, genitourinary abnormalities, or have previously received TMP-SMX within the past 90 days 7
• The institutional antimicrobial resistance rates for E. coli should be considered when selecting empiric antibiotic therapy for UTIs 7