Viridans-Group Streptococci

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Background

Types

    • Streptococcus milleri
    • Streptococcus sanguis
    • Streptococcus mitis
    • Streptococcus bovis

Risk Factors Viridans Bacteremia

  • neutropenia
  • oral mucositis
  • irradiation to the oral cavity
  • antibiotic prophylaxis with trimethoprim-sulfamethoxazole and fluoroquinolones
  • intravenous hyperalimentation
  • high dose chemotherapy

Antibiotic Sensitivities[1]

Organisms ' Viridans strep
Penicillins Penicillin G +/-
Penicillin V +/-
Anti-Staphylocccal Penicillins Methicillin +/-
Nafcillin/Oxacillin +/-
Cloxacillin/Diclox. +/-
Amino-Penicillins AMP/Amox +/-
Amox/Clav +/-
AMP-Sulb +/-
Anti-Pseudomonal Penicillins Ticarcillin +/-
Ticar-Clav +/-
Pip-Taxo +/-
Carbapenems Piperacillin +/-
Doripenem +
Ertapenem +
Imipenem +
Meropenem +
Aztreonam 0
Fluroquinolones Ciprofloxacin 0
Ofloxacin 0
Pefloxacin
Levofloxacin +
Moxifloxacin +
Gemifloxacin +
Gatifloxacin +
1st G Cephalosporin Cefazolin +
2nd G. Cephalosporin Cefotetan +
Cefoxitin +
Cefuroxime +
3rd/4th G. Cephalosporin CefoTAXime +
Cefizoxime +
CefTRIAXone +
Ceftobiprole +
Ceftaroline +
CefTAZidime +/-
Cefepime +
Oral 1st G. Cephalosporin Cefadroxil +
Cephalexin +
Oral 2nd G. Cephalosporin Cefaclor/Loracarbef +
Cefproxil 0
Cefuroxime axetil +
Oral 3rd G. Cephalosporin Cefixime +
Ceftibuten 0
Cefpodox/Cefdinir/Cefditoren +
Aminoglycosides Gentamicin
Tobramycin
Amikacin
Chloramphenicol
Clindamycin
Macrolides Erythromycin
Azithromycin
Clarithromycin
Ketolide Telithromycin
Tetracyclines Doxycycline
Minocycline
Glycylcycline Tigecycline
Glyco/Lipoclycopeptides Vancomycin
Teicoplanin
Telavancin
Fusidic Acid
Trimethoprim
TMP-SMX
Urinary Agents Nitrofurantoin
Fosfomycin
Other Rifampin
Metronidazole
Quinupristin dalfoppristin
Linezolid
Daptomycin
Colistimethate

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

Table Overview

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2010