Template:Endocarditis Empiric Antibiotics: Difference between revisions
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===Native Valves=== | ===Native Valves=== | ||
'''Options:''' | '''Options:'''<ref name="ESC Task Force">ESC Task Force Guidelines on the prevention, diagnosis, and treatment of infective endocarditis. European Heart Journal (2009) 30, 2369–2413 doi:10.1093/eurheartj/ehp285 [http://www.escardio.org/guidelines-surveys/esc-guidelines/guidelinesdocuments/guidelines-ie-ft.pdf PDF]</ref> | ||
{{Native Valve Endocarditis Antibiotics}} | {{Native Valve Endocarditis Antibiotics}} | ||
'''Suspected MRSA:''' | '''Suspected MRSA:'''<ref name="ESC Task Force"></ref> | ||
{{MRSA Native Valve Endocarditis Antibiotics}} | {{MRSA Native Valve Endocarditis Antibiotics}} | ||
===Prosthetic Valves (Early)=== | ===Prosthetic Valves (Early)=== | ||
;Early prosthetic valve endocarditis defined as < 12 months post surgery | ;Early prosthetic valve endocarditis defined as < 12 months post surgery<ref name="ESC Task Force"></ref> | ||
{{Prosthetic Valve Endocarditis Antibiotics Early}} | {{Prosthetic Valve Endocarditis Antibiotics Early}} | ||
===IV Drug User without Prosthetic Valve=== | |||
{{IVDA Endocarditis Antibiotics}} | |||
===Prosthetic Valve (Late)=== | ===Prosthetic Valve (Late)=== | ||
;Late prosthetic valve endocarditis defined as ≥ 12 months post surgery | ;Late prosthetic valve endocarditis defined as ≥ 12 months post surgery<ref name="ESC Task Force"></ref> | ||
{{Prosthetic Valve Endocarditis Antibiotics Late}} | {{Prosthetic Valve Endocarditis Antibiotics Late}} | ||
===[[Dental Procedure Prophylaxis]]=== | |||
{{Dental Procedure Endocarditis Prophylaxis Antibiotics}} | |||
===Pediatric Empiric=== | |||
*{{AntibioticDose|disease=Endocarditis|drug=Vancomycin|dose=15mg/kg IV q6hrs (max 2g/dose)|context=Pediatric Empiric|population=Pediatric}} + {{AntibioticDose|disease=Endocarditis|drug=Gentamicin|dose=1mg/kg IV q8hrs|context=Pediatric Empiric|population=Pediatric}} | |||
*{{AntibioticDose|disease=Endocarditis|drug=Nafcillin|dose=50mg/kg IV q6hrs (max 2g/dose)|context=Pediatric MSSA|population=Pediatric}} if MSSA confirmed | |||
*{{AntibioticDose|disease=Endocarditis|drug=Ceftriaxone|dose=100mg/kg/day IV divided q12h (max 4g/day)|context=Pediatric Empiric|population=Pediatric}} as alternative | |||
Latest revision as of 13:03, 20 March 2026
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 doses + Gentamicin 3mg/kg/day IV in 2 or 3 doses
- Oxacillin 2g IV six times daily 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 1g (50mg/kg) IM or IV or Ceftriaxone 1g (50mg/kg) IM or IV
- Clindamycin 600mg (20mg/kg) PO or IV
- Azithromycin 500mg (15mg/kg) PO or Clarithromycin 500mg (15mg/kg) PO
Pediatric Dosing:
- Amoxicillin 50mg/kg PO (max 2g) 1hr before procedure
- Ampicillin 50mg/kg IV/IM (max 2g) 30min before procedure if unable to take PO
- PCN allergy: Clindamycin 20mg/kg PO or IV (max 600mg) OR
- Azithromycin 15mg/kg PO (max 500mg) OR
- Cephalexin 50mg/kg PO (max 2g)
Pediatric Empiric
- Vancomycin 15mg/kg IV q6hrs (max 2g/dose) + Gentamicin 1mg/kg IV q8hrs
- Nafcillin 50mg/kg IV q6hrs (max 2g/dose) if MSSA confirmed
- Ceftriaxone 100mg/kg/day IV divided q12h (max 4g/day) as alternative