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Bacterial Endocarditis Treatment

Pathogens

Drug treatment

Empiric

Native valve

benzylpenicillin

HMLSchedNZFPMLnoids

(Penicillin G)

IV 2.4 g (4 megaunits) every four hours

AND

flucloxacillin

HMLSchedNZFPMLnoids

IV 2 g every four hours

AND

gentamicin

HMLSchedNZFPMLnoids

IV 3 mg/kg ideal body weight every 24 hours (once a day) initial dose - see gentamicin guidelines

Mild penicillin allergy

cefazolin

HMLSchedNZFPMLnoids

IV 2 g every eight hours

AND

gentamicin

HMLSchedNZFPMLnoids

IV 3 mg/kg ideal body weight every 24 hours (once a day) initial dose - see gentamicin guidelines

Severe penicillin allergy

vancomycin

HMLSchedNZFPMLnoids

See dosing guidelines (use high doses)

AND

gentamicin

HMLSchedNZFPMLnoids

IV 3 mg/kg ideal body weight every 24 hours (once a day) initial dose - see gentamicin guidelines

Prosthetic valves, implantable cardiac devices, or hospital-acquired endocarditis

flucloxacillin

HMLSchedNZFPMLnoids

IV 2 g every four hours

AND

vancomycin

HMLSchedNZFPMLnoids

See dosing guidelines (use high doses)

AND

gentamicin

HMLSchedNZFPMLnoids

IV 3 mg/kg ideal body weight every 24 hours (once a day) initial dose - see gentamicin guidelines

Penicillin allergy

Consult Infectious Diseases/Clinical Microbiology.

Pathogens Known

Consult Infectious Diseases/Clinical Microbiology.

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Topic Code: 99217