From the Research
For Aerococcus urinae infections, nitrofurantoin is a valid option for the treatment of cystitis, achieving clinical and microbiological success in 71/76% of cases, and is recommended as the first-line antibiotic treatment. The choice of antibiotic should be guided by susceptibility testing when available, as resistance patterns can vary 1. According to a prospective observational study published in 2018, nitrofurantoin was the most commonly prescribed antibiotic for A. urinae urinary tract infections, with a high success rate 1.
Key Considerations
- The duration of therapy for uncomplicated urinary tract infections caused by A. urinae is typically 7 days, but may vary depending on the severity of the infection and the patient's response to treatment.
- For more severe infections, such as pyelonephritis, ciprofloxacin may be a suitable option, as it has been shown to be effective in patients with A. urinae pyelonephritis 1.
- Susceptibility testing should be performed to guide therapy, as resistance patterns can vary, and the most recent study from 2024 found that A. urinae isolates were susceptible to penicillin, amoxicillin, meropenem, ciprofloxacin, levofloxacin, rifampicin, vancomycin, nitrofurantoin, and fosfomycin 2.
- Follow-up cultures after treatment completion are advisable to ensure eradication, particularly in complicated cases.
Treatment Options
- Nitrofurantoin: a valid option for the treatment of cystitis caused by A. urinae, with a high success rate 1.
- Ciprofloxacin: may be a suitable option for more severe infections, such as pyelonephritis 1.
- Pivmecillinam: may be effective in patients with A. urinae cystitis 1.
- Penicillin G or ampicillin: may be considered as alternative options, but susceptibility testing should be performed to guide therapy 2.