Background: Enterococcal species can cause a variety of infections, including urinary tract infections, bacteremia, endocarditis, and meningitis. Although the natural resistance of enterococci to cephalosporins is a well-known feature, we have found that physicians used cephalosporin to treat infections caused by enterococci.
Objectives: We evaluated the rationality of cephalosporins used in patients with Enterococcus faecalis or Enterococcus faecium culture reports
Methods: This retrospective study enrolled patients who have been reported with Enterococcus faecalis or Enterococcus faecium infections at a regional hospital in central Taiwan from 01/01/2019 to 12/31/2019.
Results: Exclusion criteria were outpatients, patients without using antibiotics, and patients without urinary tract infection sign. A total of 253 patients were recruited. 195 patients were reported Enterococcus faecalis and 58 patients were reported Enterococcus faecium infections. Specimen type were urine (n=117, 46%), pus (n=53, 21%), blood (n=26, 10%), wound (n=18, 7%), ascites (n=16, 6%), bile (n=15, 6%) and others (n=8, 4%). The categories of antibiotics used for the infections after the reports were penicillins (n=84, 33%), cephalosporins (n=71, 28%), glycopeptides (n=46, 18%) and others (n=52, 21%). Cephalosporin antibiotic therapies were inappropriate in 28 patients (11%) and inadequate in 24 patients (9%).
Conclusions: Almost 20% of patients were treated with inappropriate or inadequate antibiotic therapies. We expect combined infection control measures (bundle care) can reduce inappropriate rates. Furthermore, the impact of microbiological results on the clinical management of patients should be improved.
