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Template:Endocarditis Empiric Antibiotics
From WikEM
Contents
Native Valves
Options:[1]
- Ampicillin/Sulbactam 12g/day IV in 4 doses + Gentamicin 3mg/kg/day IV in 2 or 3 doses
- Amoxicillin/Clavulanate 12g/day in 4 dose + Gentamicin 3mg/kg/day IV in 2 or 3 doses
- Oxacillin or Nafcillin 2g IV six times daily + Gentamicin 1mg/kg IV three times daily AND Ampicillin 2g IV six times daily
- Daptomycin 6mg/kg IV once daily
Suspected MRSA:[1]
- Vancomycin 30mg/kg/day IV in 2 doses PLUS
- Gentamicin 3mg/kg/day IV in 2 or 3 doses PLUS
- Ciprofloxacin 1000mg/day PO in 2 doses or 800 mg/day IV in 2 doses
Prosthetic Valves (Early)
- Early prosthetic valve endocarditis defined as < 12 months post surgery[1]
- Vancomycin 30mg/kg/day IV in 2 doses PLUS
- Gentamicin 3mg/kg/day IV in 2 or 3 doses PLUS
- Rifampin 1200 mg/day PO in 2 doses
IV Drug User without Prosthetic Valve
- Vancomycin 15-20 mg/kg IV BID daily
- Daptomycin 6mg/kg IV once daily
Prosthetic Valve (Late)
- Late prosthetic valve endocarditis defined as ≥ 12 months post surgery[1]
- Same as native valve endocarditis empiric therapy
Dental Procedure Prophylaxis
All antibiotics options are given as a single dose 1 hour prior to the dental procedure
Options:[2]
- Amoxicillin 2g or 50mg/kg
- Ampicillin 2g (50mg/kg) IV or IM
- Cefazolin or Ceftriaxone 1g (50mg/kg) IM or IV
- Clindamycin 600mg (20mg/kg) PO or IV
- Azithromycin or Clarithromycin 500mg (15mg/kg) PO
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