From the Research
Nitrofurantoin is the recommended first-line antibiotic treatment for Aerococcus urinae infections, achieving clinical and microbiological success in 71/76% of cases, as demonstrated in a prospective observational study 1.
Key Points
- Aerococcus urinae is a gram-positive coccus that typically causes urinary tract infections but can lead to more serious conditions like bacteremia, endocarditis, or sepsis, particularly in elderly patients with underlying urological conditions.
- The most recent and highest quality study, published in 2023, found that Aerococcus urinae isolates are highly susceptible to nitrofurantoin, with low MICs 2.
- Other antibiotics, such as penicillin G, ampicillin, and vancomycin, may also be effective, but nitrofurantoin is the preferred choice due to its high success rate and low resistance rates.
- Antimicrobial susceptibility testing is recommended when available to guide treatment decisions.
- Treatment should be adjusted based on clinical response, with longer courses (4-6 weeks) necessary for endocarditis or other deep-seated infections.
Considerations
- Patients with penicillin allergies may require alternative treatments, such as vancomycin or nitrofurantoin.
- Gentamicin may be added for synergistic effect in severe infections like endocarditis or bacteremia.
- The choice of antibiotic should be guided by local resistance patterns and patient-specific factors, such as underlying medical conditions and potential drug interactions.
Evidence
- A prospective observational study published in 2018 found that nitrofurantoin was effective in treating Aerococcus urinae urinary tract infections, with a clinical and microbiological success rate of 71/76% 1.
- A study published in 2023 found that Aerococcus urinae isolates were highly susceptible to nitrofurantoin, with low MICs 2.
- Other studies have reported variable resistance rates to other antibiotics, highlighting the importance of antimicrobial susceptibility testing to guide treatment decisions 3, 4, 5.