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Antimicrobials
Mortality rate is as high as 25%.
Consult Infectious Disease
See also SCM orderset "Staph aureus bacteremia"
Vancomycin 25-30mg/kg IV load (max 2g) followed by 15mg/kg IV q12h maintenance for a target trough of 15-20 ug/mL
AND
Cloxacillin 2g IV q4h
OR
Cefazolin 2g IV q8h
Consult Infectious Diseases
Repeat 2 sets blood cultures q48hrs until negative
Echocardiogram required to rule out endocarditis
Identify source of infection & potential metastatic complications.
Consider; any indwelling medical device, skin and soft tissue infection, endocarditis, septic thrombophlebitis, osteomyelitis, septic arthritis, epidural abscess, pneumonia.
Remove temporary intravascular catheters present at the time the bacteremia was found and send tip for culture
If suspected to be the source, consult as appropriate for advice and/or consideration of removal of permanent vices.
Example: tunnelled lines, pacemakers, valves, graphs, prosthetic joints or other prosthetic material.
MRSA
MSSA
Reviewed September 2017