Propionibacterium acnes


Anaerobic Gram-positive nonspore-forming bacilli:
>Bifidobacterium species
>Propionibacterium Led


  • Gram-positive, rod shaped, slow-growing, nonsporeforming, anaerobic bacteria.
  • Unique metabolism: able to synthesize propionic acid by using unusual transcarboxylase enzymes.
  • Flora:  primarily facultative parasites and commensals of humans and other animals, living in and around the sweat glands, sebaceous glands, and other areas of the skin.
  • Usually innocuous, however,  have been implicated in acne and other skin conditions.
  • Species include:
    • P. acnes;
    • P. avidum;
    • P. cyclohexanicum;
    • P. freudenreichii;
    • P. granulosum;
    • P. jensenii;
    • P. microaerophilum;
    • P. propionicum

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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.   Propionibacterium strains are usually highly susceptible to penicillins, clindamycin, cephalosporins, and carbapenems .

  1. Penicillin G 2-4 million units IV q4-6h
  2. Clindamycin  600mg IV every 6 or 8 hours or 300mg orally four times daily  (~15% of strains are resistant)
  3. Ceftriaxone 1-2 grams IV q24h  (range: 1-2 grams q12-24h)
  4. Cefazolin 1 to 2 g IV every eight hours
  5. Vancomycin 1 gram  ivpb q12h (patient-specific dosing required)
  6. Linezolid 600 mg orally or IV q 12h
  7. Daptomycin 4 – 6 mg/kg IV once daily.  – NOT FOR PNEUMONIA
Propionibacterium acnes