Spectrum: Local Antimicrobial Stewardship, for AHS Calgary Zone

Prosthetic Valve IE: Empiric ABx

Prior to starting antimicrobials

  • Ensure adequate blood culture data collected.

  • Stable pt, subacute: blood culture q8h x 3

  •  Unwell pt: If possible 3 sets over 1hr

  • Sepsis/Severe sepsis/Shock: 3 sets from 3 sites STAT then ABx

Suggested Regimen

Vancomycin 25-30mg/kg IV load (max 2g) followed by 15mg/kg IV q12h maintenance for a target trough of 15-20µg/mL

AND

Gentamicin 1mg/kg IV q8h (trough < 1ug/mL)

AND

Rifampin 300mg PO q12h

Directed Therapy of IE