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The benefits of empiric therapy against vancomycin-resistant enterococci (VRE) are not established, even in patients ultimately identified with VRE bloodstream infection (BSI). Consequently, current antibiotic guidelines do not routinely recommend empiric VRE therapy; indeed, many clinicians often operate under the assumption that patients ‘die with instead of from VRE.'
Investigators in Taiwan retrospectively evaluated 28-day mortality in 134 patients with VRE BSI. For Gram-positive coverage, 46 patients received empiric anti-VRE therapy (daptomycin in 63%), and 88 received glycopeptides (vancomycin or teicoplanin). All glycopeptide recipients were switched to daptomycin within a median of 2 days after VRE was identified. The empiric anti-V…