Page 59 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 59

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
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