Propionibacterium acnes

Propionibacterium acnes

Background:

Propionibacterium: 

• 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

Therapy:

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