Prosthetic Valve IE - MRSA

Consults

Strongly consider Cardiology and Infectious Diseases consultation.

Prosthetic valve infective endocarditis secondary to Staphylococcus aureus frequently require surgical intervention for cure. Strongly consider Cardiovascular Surgery consultation.

Duration of Therapy

MSSA prosthetic valve endocarditis is treated for at least SIX weeks from the first negative blood culture.

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

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

AND

Rifampin 300mg PO q8h x SIX weeks

AND

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