Enterococcus Urinary Tract Infection

Patient Case: Enterococcus Urinary Tract Infection

A 30 year old with no PMH comes to the ED with dysuria but no flank pain. She is sent with TMP/SMX.

The urine culture from the ED grows pan-S Enterococcus spp. You review the culture and call the patient What is the best antibiotic treatment?

A) Return to ED for daptomycin
B) Continue TMP/SMX
C) Stop TMP/SMX + start amoxicillin
D) Stop TMP/SMX + start cefdinir

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Best Answer

Stop TMP/SMX + start amoxicillin

Explanation: TMP/SMX is inactive against Enterococcus spp and aminopenicillins are often considered the drug of choice. They typically maintain activity even in the setting of vancomycin resistance. Daptomycin is typically active against Enterococcus spp but requesting the patient return to the ED to receive IV daptomycin is not necessary when an oral option is available. Cephalosporins including cefdinir are not active against Enterococcus spp and will not be effective treatment for this infection.

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