Page 55 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
Infection/Condition Comments
Preferred Alternative
Staphylococcus aureus
Native Valves Regimen for β-lactam allergic:
Methicillin-susceptible Immediate type hypersensitivity to Vancomycin is inferior to cloxacillin
Staphylococcus aureus penicillin (anaphylaxis): for treatment of MSSA
Right sided endocarditis (tricuspid Cloxacillin 2gm IV q4-6h for Vancomycin 25-30mg/kg loading
valve) in uncomplicated endocarditis 2 weeks dose then 15-20mg/kg IV q12h Vancomycin therapy is
for 6 weeks recommended only for patients with
Left sided endocarditis and Cloxacillin 2gm IV q4-6h for For non-immediate type immediate-type penicillin
complicated right sided 6 weeks hypersensitivity: hypersensitivity
Cefazolin 2gm IV q8h for 4-6 weeks
Prosthetic Valves Cloxacillin 2gm IV q4h for Regimen for β-lactam allergic: Rifampicin has better penetration.
Methicillin-susceptible > 6 weeks Immediate type hypersensitivity to However to avoid the development
Staphylococcus aureus penicillin (anaphylaxis): of resistance, it should be started
PLUS Vancomycin 25-30mg/kg loading after 3-5 days of effective initial
Rifampicin 300mg PO q8h or 450mg dose then 15-20mg/kg IV q12h cloxacillin therapy and/or once the
PO q12h for > 6 weeks for > 6 weeks, bacteremia has been cleared
PLUS NATIONAL ANTIBIOTIC GUIDELINE 2008
PLUS Rifampicin 300mg PO q8h for
Gentamicin 1mg/kg IV q8h for > 6 weeks
2 weeks PLUS
Gentamicin 1mg/kg IM/IV q8h for
2 weeks
For non-immediate type:
Cefazolin 2gm IV q8h for 6 weeks
PLUS
Rifampicin 300mg PO q8h or 450mg
PO q12h for > 6 weeks
PLUS
Gentamicin 1mg/kg IV q8h for
2 weeks
HPP AMG Cardiovascular Infections 22
