Vancomycin-Resistant Enterococci (VRE)

Abstract

Vancomycin was introduced 40 years ago for use against penicillin-resistant staphylococci, but, because of its toxicity and the introduction of methicillin, vancomycin soon became an alternate agent and assumed the role of second-line therapy. With the appearance of methicillin resistance in Staphylococcus aureus (MRSA), coagulase-negative staphylococci in the past two decades and penicillin resistance in enterococci in the last decade, vancomycin has been reintroduced as an important therapeutic agent. The use of vancomycin has been increased further by the discovery of Clostridium difficile as the cause of antibiotic-associated colitis and by the finding that vancomycin given orally is effective therapy. The widespread use of vancomycin has led to the appearance of vancomycin resistance in enterococci.