From the FDA Drug Label
The success rates by pathogen for microbiologically evaluable patients are presented in Table 16 Pathogen Success Rate n/N (%) Daptomycin for Injection Comparator* Enterococcus faecalis (vancomycin-susceptible only) 27/37 (73%) 40/53 (76%) The antibiotic daptomycin has a clinical success rate of 73% against Enterococcus faecalis (vancomycin-susceptible only) in the treatment of complicated skin and skin structure infections. However, this does not directly answer the question about the best antibiotic for a male UTI with Enterococcus faecalis. Since the provided information is about complicated skin and skin structure infections and not urinary tract infections, no conclusion can be drawn about the best antibiotic for a male UTI with Enterococcus faecalis based on this data 1.
From the Research
Ampicillin or amoxicillin is the preferred first-line antibiotic treatment for male UTIs caused by Enterococcus faecalis, as supported by the most recent and highest quality study 2. The recommended dosage is amoxicillin 500 mg orally three times daily or ampicillin 500 mg orally four times daily for 7-14 days, with longer durations (10-14 days) generally preferred for male UTIs due to potential prostate involvement.
- Key considerations for treatment include:
- Ensuring adequate hydration during treatment
- Completing the full course of antibiotics even if symptoms improve quickly
- Conducting antibiotic susceptibility testing to guide therapy, as resistance patterns can vary
- Obtaining follow-up urine cultures to confirm clearance of the infection, especially in complicated cases or recurrent infections
- Alternative options, such as nitrofurantoin, may be considered in patients with penicillin allergies, but are less effective for prostate infections 3, 4.
- More severe infections or those with complications may require combination therapy with ampicillin plus gentamicin, or the use of other agents such as linezolid, which has shown efficacy and safety in enterococcal UTIs 2.