From the Guidelines
For coagulase-negative staphylococcal (CoNS) urinary tract infections, first-line antibiotic options include trimethoprim-sulfamethoxazole (TMP-SMX, 160/800 mg twice daily for 3 days) as recommended by the most recent guidelines 1. When considering treatment options, it's essential to note that CoNS frequently exhibit multidrug resistance, particularly to methicillin.
- Empiric therapy should consider local resistance patterns while awaiting culture results.
- Treatment choice should be guided by susceptibility testing.
- Other options like nitrofurantoin (100 mg four times daily for 5 days) or fluoroquinolones such as ciprofloxacin (250-500 mg twice daily for 3 days) may also be effective, but the choice of antibiotic should be based on the most recent and highest quality evidence available 1.
- In cases of resistance or complicated infections, vancomycin (15-20 mg/kg IV every 8-12 hours) or linezolid (600 mg twice daily) may be necessary.
- Beta-lactams like cefazolin (1-2 g IV every 8 hours) can be effective for susceptible strains.
- CoNS UTIs are often associated with urinary catheters or other urological procedures, so addressing these underlying factors is crucial for successful treatment.
- Adequate hydration and completing the full antibiotic course are important to prevent recurrence and complications, as supported by guidelines from reputable sources 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Antibiotics for Staphylococcus Coagulase-Negative UTI
- The following antibiotics have been studied for their effectiveness against coagulase-negative staphylococci (CoNS):
- Telavancin, daptomycin, linezolid, and tigecycline have been shown to have good activity against CoNS 2
- Penicillin G may be a more optimal treatment choice than oxacillin for Staphylococcus lugdunensis 3
- Imipenem and vancomycin have been shown to be effective against CoNS, with all isolates being sensitive to these antibiotics 4
- Arbekacin and linezolid are two new antibiotics that appear to be effective in the treatment of CoNS infections, but their precise role has not yet been identified 5
- It's worth noting that CoNS can develop resistance to antibiotics, and the emergence of multidrug-resistant strains is a concern 4, 6
- The choice of antibiotic should be guided by antimicrobial susceptibility testing to ensure effective treatment 2, 3, 4