View source for Vancomycin-resistant enterococcus

==Background==
*Enterococcus is part of normal gut flora
*Must cover both [[Enterococcus faecium]] and [[Enterococcus faecalis]]

==Antimicrobial Options<ref>Arias CA et al. Management of multidrug-resistant enterococcal infections. Clin Microbiol Infect. 2010 Jun; 16(6): 10.1111/j.1469-0691.</ref><ref>Rivera AM and Boucher HW. Current Concepts in Antimicrobial Therapy Against Select Gram-Positive Organisms: Methicillin-Resistant Staphylococcus aureus, Penicillin-Resistant Pneumococci, and Vancomycin-Resistant Enterococci. Mayo Clin Proc. 2011 Dec; 86(12): 1230–1243.</ref>==
*[[Gentamicin]] 1 mg/kg q8hrs IV
**Use [[streptomycin]] for [[gentamicin]] resistance
**Add [[ampicillin]] 12 g q24hrs IV if treating [[endocarditis]] or [[vancomycin]] if suspicious for MRSA
*[[Linezolid]] 600 mg PO/IV q12hrs, with exception of bacteremia since agent is bacteriostatic
*[[Daptomycin]] 6 mg/kg q24hrs 
**Cannot be used for pulmonary infection
**Daptomycin is inactivated by surfactant by in vitro studies

==See Also==
*[http://www.antimicrobe.org/Enterococcus%20table%202.pdf VRE antimicrobial table from www.antimicrobe.org]

==References==
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