Native Valve IE - MSSA

Duration of Therapy

In general, six weeks of therapy should be provided for both left and right sided IE.

The course starts from the first negative blood culture, and may require alteration if complications occur or the patient requires surgery/valve replacement

Suggested Regimen

Cloxacillin 2g IV q4h

OR

Cefazolin 2g IV q8h

Non-Anaphylactic Penicillin Allergy

Cefazolin 2g IV q8h

Penicillin Anaphylaxis

Vancomycin 25mg/kg IV load followed by 15mg/kg IV maintenance for a target trough of 15-20mg/L

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.

Gentamicin and/or rifampin SHOULD NOT be used for treatment of Staphylococcus aureus native valve infective endocarditis. Addition of these agents has not been shown to provide clinical benefit and increases risk of toxicity and drug interactions.