Vancomycin-Resistant Enterococci-An Updated Review for Pharmacists and Medical Secretary

Alshammari, Hamed Ateeq; Alshammri, Hatem Mazyad; Alanazi, Sami Khalid; Alanazi, Faris Abdullah; Alanazi, Meshal Ateeq S; Alzaaqi, Abdulaziz Khalid; Awaji, Abdulaziz Yahya; Alshehri, Hanan Mara M; Batt, Ahmed Nasser; Al-Ruwaithi, Thamer Mohammed Baloud; Alanazi, Sahar Sowaid; Alshammari, Majed Raji

doi:10.21608/ejchem.2025.337098.10815

Vancomycin-Resistant Enterococci-An Updated Review for Pharmacists and Medical Secretary

Document Type : Review Articles

Authors

¹ Hail General Hospital, Ministry of Health, Saudi Arabia

² Northern Area Armed Forces Hospital, Ministry of Defense, Saudi Arabia

³ King Saud Medical City, Ministry of Defense, Saudi Arabia

⁴ King Faisal Air College, Ministry of Defense, Saudi Arabia

⁵ Prince Sultan Military Medical City, Ministry of Defense, Saudi Arabia

⁶ Ministry of Defense, Saudi Arabia

10.21608/ejchem.2025.337098.10815

Abstract

Background: Vancomycin-resistant Enterococci (VRE) represent a significant challenge in hospital settings, contributing to increased morbidity, mortality, and healthcare costs. Enterococci are normally harmless gut commensals but can become pathogenic under certain conditions, leading to infections such as urinary tract infections (UTIs), bacteremia, endocarditis, and intra-abdominal infections. VRE, particularly strains of Enterococcus faecium, have developed resistance to vancomycin, complicating treatment options and requiring focused antimicrobial stewardship.

Aim: This review provides an updated overview of VRE, focusing on its etiology, resistance mechanisms, epidemiology, clinical manifestations, and treatment strategies, with particular emphasis on the role of pharmacists in managing these infections. The review also focus on the main role of medical records in documentation of this issue.

Methods: A comprehensive review of current literature was conducted to examine the mechanisms of resistance in Enterococci, the clinical impact of VRE infections, and the available therapeutic options. The review also highlights the role of pharmacists in optimizing antimicrobial therapy and infection control practices.

Results: VRE infections are primarily caused by E. faecium, which exhibits high resistance to vancomycin and other antimicrobial agents. Resistance mechanisms, including modifications in cell wall synthesis, complicate treatment regimens. Pharmacists play a key role in selecting appropriate antibiotics, optimizing dosages, and providing infection control advice. The use of linezolid and daptomycin is recommended for managing VRE infections, with careful monitoring of adverse effects.

Conclusion: The increasing prevalence of VRE necessitates comprehensive strategies involving surveillance, targeted therapy, and robust infection control. Pharmacists are essential in guiding appropriate treatment choices, monitoring therapeutic efficacy, and mitigating adverse effects, ultimately improving patient outcomes

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