From the Research
Enterococcus hirae infections should be treated with ampicillin as the first-line antibiotic, given its high susceptibility and effectiveness, as demonstrated in recent case reports 1, 2. For a typical E. hirae infection, I recommend monotherapy with ampicillin (2g IV every 4-6 hours) for uncomplicated infections.
- Treatment duration typically ranges from 10-14 days for uncomplicated infections to 4-6 weeks for endocarditis or other deep-seated infections.
- Blood cultures should be obtained before initiating antibiotics, and susceptibility testing is crucial as E. hirae can develop resistance.
- E. hirae is a gram-positive coccus that primarily affects the urinary and gastrointestinal tracts but can cause serious infections including bacteremia, endocarditis, and meningitis, particularly in immunocompromised patients.
- The bacterium possesses intrinsic resistance to several antibiotics, making it challenging to treat.
- Close monitoring of renal function is necessary when using antibiotics, and follow-up cultures should be obtained to ensure clearance of the infection.
- Source control (such as removal of infected catheters or drainage of abscesses) is essential for successful treatment, as highlighted in recent studies 3, 4.
- In cases where ampicillin is not suitable, alternative antibiotics such as linezolid or vancomycin may be considered, as discussed in the literature 5, 2.