Tailor Antimicrobial Therapy Based on Gram Strain

Gram Positive Cocci

Continue only vancomycin until culture and susceptibilities available.

Suspect Neisseria gonorrhea. Take a complete sexual history and perform testing for sexually transmitted infections.

Discontinue vancomycin.
Continue ceftriaxone only.

AND

If gonococcal infection confirmed, also give:

Azithromycin 1g PO x 1 dose for pre-emptive treatment of chlamydial infection.

Discontinue vancomycin.
Continue ceftriaxone only until culture and susceptibilities available.