Prosthetic Valve IE - CoNS (clox susceptible)

Duration of Therapy

Six weeks from first negative blood culture, and may require alteration if complications occur or the patient requires valve surgery

Strongly consider Infectious Diseases consultation.

Suggested Regimen

Cloxacillin 2g IV q4h x 6 weeks

AND

Rifampin 300mg PO q8h x 6 weeks

AND

Gentamicin 1mg/kg q8h (trough 1-2mg/L) x 2 weeks

Non-Anaphylactic Penicillin Allergy

Cefazolin 2g IV q8h x 6 weeks, with the addition of gentamicin and rifampin as above.

Penicillin Anaphylaxis

Vancomycin 25mg/kg IV load followed by 15mg/kg IV maintenance for a target trough of 15-20mg/L, with the addition of gentamicin and rifampin as above.

Review nature of allergy and consider desensitization procedure for a penicillin/cephalosporin (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.