For infections caused by vancomycin-resistant enterococci (VRE), which agent is indicated?

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Multiple Choice

For infections caused by vancomycin-resistant enterococci (VRE), which agent is indicated?

Vancomycin resistance in enterococci arises when the bacteria modify the drug’s binding target, so vancomycin cannot inhibit cell-wall synthesis. Infections due to VRE require an agent with activity against these resistant strains and a different mechanism. Linezolid fits this need because it inhibits protein synthesis by binding to the 50S ribosomal subunit, a mechanism not affected by the vancomycin resistance mechanism. It effectively covers Enterococcus species, including vancomycin-resistant strains, and can be used for serious infections with flexible IV or oral administration. The other options lacking reliable activity against VRE: ampicillin is often ineffective against VRE, ceftriaxone has poor activity against Enterococcus, and vancomycin itself is ineffective due to resistance.

Vancomycin resistance in enterococci arises when the bacteria modify the drug’s binding target, so vancomycin cannot inhibit cell-wall synthesis. Infections due to VRE require an agent with activity against these resistant strains and a different mechanism. Linezolid fits this need because it inhibits protein synthesis by binding to the 50S ribosomal subunit, a mechanism not affected by the vancomycin resistance mechanism. It effectively covers Enterococcus species, including vancomycin-resistant strains, and can be used for serious infections with flexible IV or oral administration. The other options lacking reliable activity against VRE: ampicillin is often ineffective against VRE, ceftriaxone has poor activity against Enterococcus, and vancomycin itself is ineffective due to resistance.

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