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Related Experiment Videos

Treatment options for vancomycin-resistant enterococcal infections.

Peter K Linden1

  • 1Division of Critical Care Medicine, University of Pittsburgh Medical Center, Room 602-A Scaife Hall, 200 Lothrop Street, Pittsburgh, PA 15213, USA. lindenpk@anes.upmc.edu

Drugs
|February 6, 2002
PubMed
Summary

New antimicrobial agents, quinupristin/dalfopristin and linezolid, show promise for treating vancomycin-resistant enterococci (VRE) infections in high-risk patients. Further research is needed to establish optimal use and comparative efficacy against VRE.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Serious vancomycin-resistant enterococci (VRE) infections occur in immunocompromised patients, necessitating effective antimicrobial treatments.
  • Treatment options for VRE are limited, with some agents lacking specific VRE approval and others showing promise in vitro or in animal models.
  • Novel agents like quinupristin/dalfopristin and linezolid have emerged as approved options for VRE infections, particularly vancomycin-resistant Enterococcus faecium.

Purpose of the Study:

  • To review the efficacy and safety of emerging antimicrobial agents for vancomycin-resistant enterococci (VRE) infections.
  • To discuss the mechanisms of action, clinical trial results, and adverse effects of quinupristin/dalfopristin and linezolid.
  • To highlight the current landscape of VRE treatment, including investigational agents and strategies for reservoir suppression.

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Main Methods:

  • Review of clinical trial data for quinupristin/dalfopristin and linezolid in VRE infections.
  • Analysis of in vitro susceptibility data and mechanisms of action for novel antimicrobial agents.
  • Summary of reported outcomes, resistance patterns, and adverse effects associated with these treatments.

Main Results:

  • Quinupristin/dalfopristin demonstrated a 65.8% overall response rate in VRE infections, with 1.8% resistance observed.
  • Linezolid showed high cure rates across various infection sites (e.g., 90.9% for primary bacteremia) and a dose-response relationship in a randomized trial.
  • Adverse effects included myalgia/arthralgia for quinupristin/dalfopristin and gastrointestinal issues/thrombocytopenia for linezolid.

Conclusions:

  • Quinupristin/dalfopristin and linezolid represent significant advancements in treating VRE infections, offering effective options for difficult-to-treat cases.
  • Further comparative studies are needed to establish the optimal use of these agents and their roles in combination therapy.
  • Investigational agents and strategies targeting VRE reservoirs offer future therapeutic possibilities for infection control and prevention.