Pathogens
Enterococcus faecium

Enterococcus faecium

Precautions

Standard Precautions

General Information

Ampicillin-Sensitive

  • Ampicillin
  • Amoxicillin
  • Penicillin

Ampicillin-resistant, Vancomycin-sensitive

  • Vancomycin
  • Amoxicillin OK for urine isolates

VRE

  • Linezolid
  • Ampicillin or amoxicillin for uncomplicated cystitis

Add gentamicin or streptomycin when cidal activity is required (eg for endocarditis) and agents are susceptible for synergy

Ampicillin-Sensitive

  • Vancomycin
  • Linezolid
  • Piperacillin/tazobactam
  • Daptomycin
  • Tigecycline

Ampicillin-resistant, Vancomycin-sensitive

  • Linezolid
  • Daptomycin

VRE

  • Daptomycin
  • Tigecycline

Add gentamicin or streptomycin when cidal activity is required (eg for endocarditis) and agents are susceptible for synergy

Gram positive cocci in short chains

Nosocomial (esp. VRE), associated with prior antibiotics

Colonization

More likely to cause true infection in immunocompromised or after selection pressure from antimicrobial administration has eliminated other organisms

Bacteremia, endocarditis (usually subacute), intra-abdominal or hepatobiliary infection, UTI

Most E. faecium will be VRE