What antibiotics cover urinary infections caused by Staphylococcus (Staph) coagulase-negative bacteria?

From the Guidelines

For urinary tract infections caused by coagulase-negative staphylococci, vancomycin is the recommended antibiotic, especially in cases of complicated infections or in hospitalized patients, as suggested by the most recent guidelines 1. When considering treatment options, it's crucial to prioritize the most recent and highest quality studies to ensure the best outcomes in terms of morbidity, mortality, and quality of life. The choice of antibiotic should be guided by susceptibility testing due to the frequent resistance of coagulase-negative staphylococci to multiple antibiotics, particularly methicillin. Some key points to consider in the management of urinary tract infections (UTIs) caused by coagulase-negative staphylococci include:

• First-line options for uncomplicated cases may include trimethoprim-sulfamethoxazole or nitrofurantoin, but these should be chosen based on local resistance patterns and patient-specific factors 1.
• For more complicated infections, such as those involving systemic symptoms or in patients with underlying complicating factors, intravenous antibiotics like vancomycin, cefazolin, or nafcillin may be necessary 1.
• The duration of treatment should be tailored to the specific syndrome and antimicrobial class used, with guidelines suggesting 3 to 14 days of therapy depending on the complexity of the infection and the patient's response 1.
• It's also important to manage any underlying urological abnormalities and to ensure adequate hydration and follow-up urine cultures after treatment completion to confirm resolution of the infection. Given the potential for resistance and the variability in treatment guidelines, vancomycin stands out as a recommended option for complicated UTIs caused by coagulase-negative staphylococci, especially in settings where resistance to other antibiotics is a concern 1.

From the Research

Antibiotics for Urinary Infections by Staph Coagulate Negative

• The choice of antibiotics for urinary infections caused by coagulase-negative Staphylococci (CoNS) depends on the specific species and its antimicrobial resistance profile 2, 3.
• Common antibiotics used to treat CoNS infections include:
  • Vancomycin and Linezolid, to which all isolates were sensitive in one study 3.
  • Other antibiotics such as trimethoprim, penicillin, and methicillin may be effective, but resistance rates can be high 2, 3.
• The following antibiotics may be used to treat less serious CoNS infections:
  • Lincosamides (clindamycin, lincomycin) or cotrimoxazole for non-multiresistant community-acquired strains 4.
• It is essential to note that CoNS can produce biofilms, which may affect the efficacy of antibiotic treatment 2, 3.
• Antibiotic resistance patterns and virulence factors, such as the presence of icaC and icaA genes, can influence the choice of antibiotic therapy 2.
• The distinction between staphylococci and micrococci, which can be made based on their sensitivity or resistance to novobiocin, may have therapeutic and epidemiological significance 5.