Infective Endocarditis - Native valve endocarditis

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

Micro Organisms

Strep. viridians, Staph. aureus

 

Rarely; HACEK organisms

First Line

Therapy

Amoxicillin IV + Gentamicin IV (treatment dose, not synergistic dose) +/- Flucloxacillin IV

Total antibiotic duration: 4-6 weeks

Discuss with specialist for course length of gentamicin

Use high dose amoxicillin and flucloxacillin

Notes:

Penicillin Allergy or MRSA suspected or confirmed

Therapy

Vancomycin IV + gentamicin IV (treatment dose, not synergistic dose)

Total antibiotic duration: 4 -6 weeks

Discuss with specialist for course length of gentamicin

 

Notes:

Target vancomycin level - Trough: 15-20mg/l for pulsed infusion.

Notes

Use paediatric gentamicin for dosing guidance and target levels

Rationalise antibiotic regimen based on C + S results