|
|
||||
|
Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
||||
|
ISSN 1681-715X |
||||
|
||||
|
- |
||||
|
ORIGINAL ARTICLE |
||||
|
- |
||||
|
Volume 22 |
July - September 2006 |
Number 3 |
||
|
|
||||
|
|
||||
|
|
||||
|
Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
||||
|
ISSN 1681-715X |
||||
|
||||
|
- |
||||
|
ORIGINAL ARTICLE |
||||
|
- |
||||
|
Volume 22 |
July - September 2006 |
Number 3 |
||
|
|
||||
|
|
||||
Antibiotic Options for Enterococcus Faecalis Infections
Farhan E. Abdulla, Essa M. Abdulla
ABSTRACT
Objective: Escalating resistance of enterococci to many antimicrobials poses a major therapeutic challenge; vancomycin-resistant enterococci (VRE), in particular, exhibit variation in resistance patterns, demanding tailored drug prescription. Hence we screened the in vitro sensitivity profiles of 112 local clinical isolates using 13 antibiotics for their possible therapy options biased by the site of infection.
Setting: Specimens yielding enterococci referred by local hospitals (n=103) and private physicians (n=09) were processed during a two-year period ending September 2005 at Dr. Essa’s Lab in Karachi, Pakistan.
Methods: Consecutive Enterococcus faecalis strains cultured from urine (n=78), pus (n=18), blood (n=12), HVS (n=2) and ascitic fluid (n=2) were challenged in vitro with locally available antibiotics using the standard disc diffusion method; MICs of one VRE isolate were also performed.
Results: Vancomycin (99.1%) and teicoplanin (99.1%), followed by nitrofurantoin (97.3), fosfomycin (91.0%) and chloramphenicol (78.5%), were more effective than pipericillin-tazobactam (72.3%), ampicillin (54.4%), meropenem (45.5%) and ciprofloxacin (35.7%). Gentamicin and cotrimoxazole offered ineffective zones of inhibition. Only a single VRE strain, also teicoplanin-resistant, was encountered.
Conclusion: Increasing drug resistance of enterococci warrants concern and the search for possible therapeutic options prejudiced by local patterns of resistance and the site of infection. Vancomycin, teicoplanin, nitrofurantoin and chloramphenicol are also significantly effective on our current isolates and fosfomycin, typically considered a urinary drug, but encouraged by reports of its successful use in diverse sites, is discussed as a possible alternative.
Key words: Enterococci, VRE, Treatment options, Nitrofurantoin, Fosfomycin.
Pak J Med Sci July - September 2006 Vol. 22 No. 3 286-290
HOME | SEARCH | CURRENT ISSUE | PAST ISSUES
Professional
Medical Publications
Room No. 522, 5th Floor, Panorama Centre
Building No. 2, P.O. Box 8766, Saddar, Karachi - Pakistan.
Phones : 5688791, 5689285 Fax : 5689860
pjms@pjms.com.pk
