8/27/2006 Infective Endocarditis
Terms
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- Streptococcus viridans (3)
-
1) penicillin 12-18 million units/day divided q4hr x 2wks AND gentamicin 1mg/kg q8hr x 2wks
2)penicillin allergic: ceftriaxone 2gm IV q24hr AND gentamicin 1mg/kg q8hr both x 2wks
3)vancomycin 15mg/kg q12hr x4wks - Staph aureus (4)
-
1)Nafcillin 2gm IV q4hr x 4-6wks AND gentamicin 1mg/kg IV q8hr x 3-5days
2)cefazolin 2gm IV q8hr x4-6wks AND gentamicin 1mg/kg IV x 3-5days
3)vancomycin 15mg/kg IV q12h x 4-6wks
4)vancomycin 1gm IV q12hr x 4-6wks - Staph epi (2)
-
1)nafcillin 2gm IVPB q4hr AND rifampin 300mg TID for >6wks AND gentamicin 1mg/kg q8hr x 2wks
2)vancomycin 15mg/kg IV q12hr AND rifampin 300mg q8hr for >6wks AND gentamicin 1mg/kg IV q8hr x 2wks -
Enterococcus
1)high level aminoglycoside resistance
2)penicillin resistant
3)intrinsic penicillin G/ampicillin resistance
4)VRE -
1)penicillin G or ampicillin IV x8-12wks
2)Unasyn 3gm IV q6hr AND gentamicin 1-1.5mg/kg q8hr IV x 4-6wks
3)vancomycin 15mg/kg IV in 2 divided doses AND gentamicin 1-1.5mg/kg q8hr x 4-6wks
4)Synercid or linezolid - HACEK
-
1)ceftriaxone 2gm q24hr x 4wks
2)ampicillin AND gentamicin - pseudomonas
- ceftazidime or zosyn AND aminoglycoside (high dose tobramycin)
- Candidia or aspergillus
- amphotericin B 1mg/kg IV daily +/- an azole
-
Prosthetic valve endocarditis (PVE)
a)ealry (<2months)
b)late (>2months post op) -
a)Vanco 15mg/kg q12h IV AND gentamicin 1mg/kg IV q8hr AND rifampin 600mg PO q24hr
b) same -
Prophylactic regimens
(dental) -
1)amoxicillin 2g PO 1hr before procedure
2)clarithromycin or azithromycin 500mg PO 1 hr before procedure
3)clindamycin 600mg PO 1 hr before procedure -
Prophylactic regimens
(GI/GU procedures) -
1)ampicillin 2g IV AND gentamicin 1.5mg/kg IV within 30min preop; 6hr later, ampicillin 1g IV, or amoxicillin 1g PO
2)Vancomycin 1g IV AND gentamicin 1.5mg/kg IV within 30 min preop