Use of Bacitracin Therapy for Infection Due to Vancomycin-Resistant Enterococcus faecium

Vancomycin-Resistant Enterococci

“…Two groups reported more promising results with oral bacitracin. In one study, treatment cleared VRE from stools in six of eight patients, with one relapse; in the other study, bacitracin cleared VRE in eight of eight patients, with two recurrences (47,197). In another study, however, while combination therapy with bacitracin plus doxycycline initially cleared VRE from the stools of all treated patients, with longer follow-up only 33% remained free of detectable VRE, a proportion comparable to that in an untreated control group (M. R. Weinstein, J. Brunton, I. Campbell, et al, Program Abstr.…”

“…Doxycycline and minocycline have been used in the treatment of VRE infections, often with other agents. While successes have been described, it is difficult to assess their overall effectiveness (47,176). The high rate of tetracycline resistance, especially among clinically important gram-positive cocci, has limited its effectiveness (77,239).…”

Antimicrobial Growth Promoters Used in Animal Feed: Effects of Less Well Known Antibiotics on Gram-Positive Bacteria

“…Bacitracin is more stable as a zinc salt (166) and is used both as a growth promoter and in some topical preparations in human and veterinary medicine. It has also been tested, with limited success, for its applicability in the elimination of vancomycin-resistant enterococci (21,55,102,165,234).…”

Incidence and outcome of vancomycin-resistant enterococcal bacteremia following autologous peripheral blood stem cell transplantation

“…every 6 h has been utilized with moderate success and without any significant and irreversible adverse hematologic sequelae. 22 Other agents such as doxycycline, 23 nitrofurantoin, 24 co-trimoxazole and oral bacitracin 25 have also been used to treat VRE infection. Oral bacitracin was utilized in the treatment of two of our patients with persistent bacteremia as an adjunct to other anti-microbial agents.…”

“…The rationale was based on previous reports suggesting reduction or elimination of fecal carriage of VRE following the administration of oral bacitracin. 25,26 Since it is our assumption that the primary source of VRE was the gastro-intestinal tract in our patients, oral bacitracin was utilized in an effort to decrease the VRE bacterial load in the gut. It must be stated that oral bacitracin, an agent that is not absorbed from the gut, was not used to treat the actual VRE bacteremia.…”