Lactobacillus species

Background:

Anaerobic Gram-positive nonspore-forming bacilli:
>Actinomyces,
>Bi?dobacterium species
>Eubacterium
>Lactobacillus led
>Propionibacterium

>Lactobacillus species (several e.g.  L. acidophilus,L. brevis, L. buchneri, L. casei,
      L. fermentum, L. gallinarum , L. gasseri)

Lactobacillus

  • Gram-positive facultative anaerobic or microaerophilic rod-shaped bacteria.
  • Major part of the lactic acid bacteria group (convert lactose and other sugars to lactic acid).
  • Flora: present in the vagina and the gastrointestinal tract (make up a small portion of the gut flora).
  • They are usually benign, except in the mouth where they have been associated with cavities and tooth decay (dental caries).
  • Some strains of Lactobacillus spp. and other lactic acid bacteria may possess potential therapeutic properties including anti-inflammatory and anti-cancer activities, as well as other features of interest (e.g. restore physiological balance in the vaginal cavity. ) 

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.   Many species of Lactobacilli are beneficial, however, some strains may lead to more serious infections (especially in immunocompromised individuals with prolonged hospitalization).
> Most uniformly active antimicrobial agents are the penicillins and carbapenems.
> strain-related resistance to glycopeptides  – vancomycin should not be used without susceptibility testing.

  1. Penicillin G 2-4 million units IV q4-6h
  2. Ampicillin 2 grams IVPB every 4-6 hours
  3. Clindamycin  600mg IV every 6 or 8 hours
  4. Imipenem 500mg IV every 6 hours.

Disclaimer

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