From the Guidelines
Peptoniphilus infections should be treated with antibiotics effective against anaerobic bacteria, such as metronidazole, as recommended by guidelines for the treatment of intra-abdominal infections 1. When considering the treatment of Peptoniphilus infections, it is essential to note that these bacteria are anaerobic, Gram-positive organisms that can cause infections in various sites, including the abdomen, skin, and urogenital tract.
- Key characteristics of Peptoniphilus species include their ability to ferment peptones and produce butyric acid.
- They are normally found in the human gut, urogenital tract, and skin, but can act as opportunistic pathogens in certain circumstances.
- Infections caused by Peptoniphilus can be challenging to diagnose due to their strict anaerobic growth requirements and biochemical properties, often necessitating specialized laboratory techniques or molecular methods for identification. According to the guidelines for the diagnosis and management of complicated intra-abdominal infection in adults and children, coverage for obligate anaerobic bacilli, such as Peptoniphilus, should be provided for distal small bowel, appendiceal, and colon-derived infections, as well as for more proximal gastrointestinal perforations in the presence of obstruction or paralytic ileus 1.
- The recommended antibiotic regimens for the treatment of community-acquired intra-abdominal infections of mild-to-moderate severity include metronidazole in combination with other agents, such as cefazolin, cefuroxime, ceftriaxone, cefotaxime, levofloxacin, or ciprofloxacin 1.
- The choice of antibiotic should be guided by local microbiologic data, cost advantage, allergies, and formulary availability, as well as susceptibility testing when available. It is crucial to consider the potential for antimicrobial resistance among anaerobic bacteria, including Peptoniphilus, when selecting an antibiotic regimen, and to avoid the use of broad-spectrum agents when possible to minimize the risk of promoting resistance 1.
From the Research
Peptoniphilus Overview
- Peptoniphilus asaccharolyticus is a Gram-positive anaerobic coccus that forms part of the normal flora and human commensals of the skin, genitourinary system, and gut 2.
- It can cause opportunistic infections in immunocompromised patients and is frequently isolated as part of polymicrobial spectra 2.
Infection and Treatment
- Anaerobic infections, including those caused by Peptoniphilus, can occur at all body sites, including the central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin, and soft tissues 3, 4.
- Treatment of anaerobic infections is complicated by the slow growth of these organisms, their polymicrobial nature, and the growing resistance of anaerobes to antimicrobials 5, 3, 4.
- Effective antimicrobials against anaerobic organisms include metronidazole, carbapenems, combinations of a beta-lactam and a beta-lactamase inhibitor, chloramphenicol, tigecycline, and clindamycin 5, 3, 4.
- Metronidazole is still considered the drug of choice for the treatment of anaerobic infections due to its low cost, good activity against pathogenic anaerobic bacteria, favorable pharmacokinetic and pharmacodynamic properties, and minor adverse effects 6.