Anti-Enterococcal Antibiotics in Intra-Abdominal Infections

is receiving chemotherapy for colon cancer and admitted to the ICU with septic shock from an intra-abdominal infection.

Should coverage for Enterococcus spp. be considered?

How did others respond?

Reveal the answer

Best Answer:

Yes, cover Enterococcus 🦠

Explanation: Enterococcus spp, which is part of normal GI flora, rarely cause infection in healthy patients. Empiric activity is typically NOT needed in mild/moderate community-onset intra-abdominal infections.

In our patient 👴🏽 there are risk factors we should consider!

2024 Surgical Infection Society guidelines recommend empiric antibiotics against Enterococcus 🦠 in hospital-onset or severe disease such as:
-sepsis/shock
-age >70
-delayed/inadequate source control
-diffuse peritonitis
-multiple comorbidities