AN ANALYSIS OF TREATMENT OF PATIENTS WITH VANCOMYCIN-RESISTANT ENTEROCOCCAL BACTEREMIA

Vancomycin-resistant enterococci (VRE) have become a major cause of no socomial infections. If the organism is resistant or the patient is al lergic to penicillin, proven therapy does not exist. To evaluate the t reatment of patients with vancomycin-resistant enterococcal bacteremia (VREB), we reviewed the therapy for 69 patients With VREB at 13 New J ersey hospitals that had five or more cases of VREB. Prior treatment o i these patients with vancomycin was common. Susceptibility patterns v aried according to the hospital, and clinicians employed many differen t combinations of antimicrobial agents to treat these infections. Lowe r mortality rates (34% vs. 61%, P =.031; 95% Cl -49.8% to -4.2%) were achieved in patients who received al least one antimicrobial agent to which their organism was susceptible. Overall, mortality was 46%, and of these deaths, 72% were judged to be directly related to VREB. Optim al therapy remains to be determined.