Spectrum: Local Antimicrobial Stewardship, for AHS Calgary Zone

Tx Grp B/C/G IE

Consults

These organisms are rare causes of endocarditis - recommend ID Consultation

Duration of Therapy

4-6 weeks for the beta-lactam and 2 weeks of gentamicin

Suggested Regimen

Gentamicin 3mg/kg IV daily x TWO weeks

AND EITHER

Penicillin 4MU IV q4h

OR

Cefazolin 2g IV q8h

Hold Gentamicin if risk too high but should be given if prosthetic valve IE

Non-Anaphylactic Penicillin Allergy

Ceftriaxone 2g IV daily INSTEAD OF Penicillin/Cefazolin in above regimen

Penicillin Anaphylaxis

Vancomycin 25-30mg/kg IV load (max 2g) followed by 15mg/kg IV q12h maintenance for a target trough of 10-15µg/mL INSTEAD OF Penicillin/Cefazolin in above regimen

Review nature of allergy and consider desensitization procedure for a beta-lactam (optimal therapy)

Desensitization procedure

Drug to which patient has an immediate hypersensitivity reaction, is administered in increasing increments to allow TEMPORARY tolerance of the drug for a period of required therapy.

Reassess Therapy on Day 3

Day 3 Bundle