Spectrum: Local Antimicrobial Stewardship, for Saskatchewan Health Authority - Saskatoon Area

Prosthetic Valve IE - CoNS (cloxacillin resistant)

Duration of Therapy

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

Suggested Regimen

Vancomycin 25 mg/kg IV load followed by 15mg/kg IV maintenance for a target trough of 15-20µg/mL x 6 weeks

View vancomycin nomogram

AND

Rifampin 300mg PO q8h x SIX weeks

AND

Gentamicin 1mg/kg IV q8h (trough 1-2µg/mL) x TWO weeks