Page 50 - HPP ANTIMICROBIAL GUIDELINE 2018
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CARDIOVASCULAR INFECTIONS
A. INFECTIVE ENDOCARDITIS
Suggested Treatment
Infection/Condition Comments
Preferred Alternative
Empirical Treatment
Community acquired native Ampicillin 12g IV in 4-6 divided For patients who are allergic to Duration of treatment = 6 weeks
valves or doses B-lactam antimicrobials:
late prosthetic valves * for patients with suspected
(≥ 12 months post-surgery) PLUS Vancomycin 15-20mg/kg/dose S. aureus infections (such as IVDU
endocarditis Gentamicin 3mg/kg/d IV q24h IV q12h; not to exceed 2g/dose or patients with prosthesis) and
acute presentation
PLUS/MINUS PLUS
*Cloxacillin 12g IV in 4-6 divided Gentamicin 3mg/kg/d IV q24h
doses (see comments)
Early prosthetic valves Vancomycin 15mg-20mg/kg/dose **Rifampicin is only recommended
(< 12 months post-surgery) or IV q12hr; not to exceed 2g/dose for prosthetic valve endocarditis
nosocomial and non-nosocomial and it should be started 3-5 days
healthcare associated PLUS later than vancomycin and
endocarditis Gentamicin 3mg/kg/day IV q24h gentamicin
PLUS/MINUS ^Cefepime is indicated if local
**Rifampicin 300-450mg PO q12h epidemiology suggests for non-
HACEK Gram negative rod
PLUS/MINUS infection (such as Pseudomonas)
^Cefepime 2g IV q8h
HPP AMG Cardiovascular Infections 20
