Streptococcus pneumoniae

Streptococcus pneumoniae

Background:
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Streptococci
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>Streptococcus anginosus group (formerly Streptococcus milleri)
     1] Streptococcus intermedius
     2] Streptococcus anginosus
     3] Streptococcus constellatus
>Streptococcus pneumoniae Led
>Streptobacillus moniliformis
>Streptococcus pyogenes (Groups A, B, C, G, F)
>Streptococcus agalactiae  (Group B streptococcus)

Streptococcus pneumoniae:

  •   (AKA pneumococcus.  Gram-positive, alpha-hemolytic, aerotolerant, anaerobic streptococcus.
  • -Found normally in the nasopharynx of healthy carriers.
  • -Significant human pathogen.(main cause of community acquired pneumonia and meningitis in children and the elderly, and of septicemia in HIV-infected persons.)
  • -Several other possible infections may occur including: acute sinusitis, otitis media, conjunctivitis, meningitis, bacteremia, sepsis, osteomyelitis, septic arthritis, endocarditis, peritonitis, pericarditis, cellulitis, and brain abscess.   Also, one of the most common causes of bacterial meningitis in adults and young adults.

 

 
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Therapy:
Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first.  Listed dosages may need to be adjusted for renal dysfunction. 

  1. Penicillin G 2-4 million units IV q4-6h or Ampicillin 2 grams IVPB every 4-6 hours
  2. Ampicillin-sulbactam 1.5 – 3 grams IV q6h
  3. Clindamycin  600mg IV every 6 or 8 hours or 300mg orally four times daily 
  4. Ceftriaxone 1-2 grams IV q24h
  5. Moxifloxacin 400mg orally/IV qd
  6. Levofloxacin 500mg – 750 mg IV/PO once daily
  7. Imipenem 500mg IV every 6 hours.
  8. Vancomycin 1 gram  ivpb q12h (patient-specific dosing required)
  9. Linezolid 600 mg orally or IV q12h
  10. Ceftaroline  600mg IV q12h
  11. Others
Streptococcus pneumoniae