Page 58 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/Condition Comments
Preferred Alternative

C burnetti (Q fever) Doxycycline 100mg PO q12h Duration of treatment: 18-24 months
based on clinical and serological
PLUS response
Hydroxychloroquine 600mg PO
q24h

Bartonella spp Doxycycline 100mg PO q12h for
6 weeks

PLUS

Gentamicin 3mg IV q24h for
2 weeks

Therapy for Candida Endocarditis (Native and Prosthetic valve)

Candida Endocarditis Amphotericin B 0.6 -1.0mg/ kg IV Step down therapy:
q24h for at least 6/52 after surgery Fluconazole 400-800mg
(6-12mg/kg) orally daily for
PLUS/MINUS susceptible organism and in stable
Flucytosine 100mg/kg/day PO q6-8h patients with culture clearance
for at least 6/52 after surgery

• Valve replacement is mandatory. Continue therapy for 6 weeks after replacement or longer in patient with perivalvular abscess
• If prosthetic valve cannot be replaced, lifelong suppressive therapy with fluconazole 400mg (6mg/kg) daily is recommended
• The duration of therapy will depend on patient response and surgical intervention
• All patients with Candida IE should be referred to ID physician

HPP AMG Cardiovascular Infections 24