Antibiotic therapy for Enterococcus bacteraemia: warning for the antimicrobial stewardship team

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Pharmacology

Background:

• Enterococci are common causes of healthcare-associated infections (HCAI) bacteraemia.
• Enterococci exhibit resistance to common antibiotics like cephalosporins and aminoglycosides.
• Inefficient antimicrobial therapy contributes to poor patient outcomes in bacteraemia.

Purpose of the Study:

• To determine the rate of inefficient antimicrobial therapy for Enterococcus bacteraemia.
• To assess the impact of therapy efficiency on short-term patient outcomes.

Main Methods:

• Retrospective multicentre cohort study in 6 French institutions.
• Inclusion criteria: positive blood cultures for Enterococcus spp. in 2016.
• Data collection via laboratory databases and hospital record review.

Main Results:

• 131 patients included; 54% had HCAI.
• 43% of empirical and 17% of documented therapies were inefficient.
• Amoxicillin use as documented therapy was associated with better short-term outcomes (p=0.001).

Conclusions:

• Enterococcal bacteraemia frequently involves inefficient antimicrobial therapy.
• Amoxicillin use in documented therapy is associated with improved outcomes.
• Optimizing antibiotic selection is crucial for managing Enterococcus bacteraemia.