Page 56 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 56

Suggested Treatment
                        Infection/Condition                                                                                         Comments
                                                               Preferred                         Alternative


                 Native valves                     Vancomycin 25-30mg/kg loading
                 Methicillin-resistant             dose then 15-20mg/kg IV q12h for
                 Staphylococcus aureus             6 weeks, not to exceed 2g/dose



                 Prosthetic valves                 Vancomycin 25-30mg/kg loading
                 Methicillin-resistant             dose then 15-20mg/kg IV q12h for
                 Staphylococcus aureus             ≥ 6 weeks, not to exceed 2g/dose

                                                   PLUS

                                                   Rifampicin 450mg PO q12h for
                                                   ≥ 6 weeks

                                                   PLUS

                                                   Gentamicin 1mg/kg IV q8h for
                                                   2 weeks

                 HACEK Microorganisms              Ceftriaxone 2gm IV q24h for        Ampicillin/sulbactam 3gm IV q6h for
                                                   4 weeks (native valve)             4 weeks (native valve) or 6 weeks
                                                   or                                 (prosthetic valve)
                                                   6 weeks (prosthetic valve)
                                                                                      OR
                                                                                      Ciprofloxacin 400mg IV q12h or
                                                                                      500mg PO q12h for 4 weeks (native
                                                                                      valve) or 6 weeks (prosthetic valve)


                 Brucella spp                      Doxycycline 100mg PO q12h                                             Doxycycline and rifampicin should
                                                   PLUS                                                                  be continued for 3-6 months
                                                   Rifampicin 300-600mg q24h
                                                                                                                         Streptomycin or gentamicin for
                                                   PLUS                                                                  2-3 weeks
                                                   Streptomycin 1gm IM q24h
                                                   Or
                                                   Gentamicin 5mg/kg IV q24h



               HPP AMG                                                    Cardiovascular Infections                                                      23
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