From the Research
For treating Aerococcus urinary tract infections, nitrofurantoin is a valid option, achieving clinical and microbiological success in 71/76% of cases of A. urinae UTI, and 42/50% of cases of A. sanguinicola UTI, as shown in a prospective observational study 1.
Treatment Options
- Nitrofurantoin is a recommended treatment option, especially for uncomplicated UTIs, with a dosage of 100mg twice daily for 5-7 days.
- Pivmecillinam is also effective for A. urinae cystitis, and ciprofloxacin can be used for pyelonephritis, as demonstrated in the study 1.
- Penicillin or ampicillin can be considered as alternative options, although resistance rates and patient allergies should be taken into account, as noted in various studies 2, 3, 4.
Important Considerations
- Aerococcus species are gram-positive cocci that typically respond well to beta-lactam antibiotics, which target the bacterial cell wall synthesis.
- Ensuring adequate hydration during treatment and completing the full course of antibiotics, even if symptoms improve before completion, is crucial for effective treatment.
- Follow-up urinalysis may be necessary to confirm resolution of the infection, especially in complicated cases or recurrent infections.
Antibiotic Resistance and Susceptibility
- Aerococcus urinae isolates have shown susceptibility to penicillins, carbapenems, and vancomycin, with some isolates exhibiting synergy between penicillin and aminoglycosides 3, 4.
- Resistance to fluoroquinolones and sulfonamides has been reported, highlighting the need for careful selection of antibiotics and consideration of patient-specific factors 2, 5.