Spectrum: Local Antimicrobial Stewardship, for Providence Health Care

MRSA

Initial Empiric Treatment

Vancomycin 25 mg/kg loading dose followed by 15-20 mg/kg IV, target trough of 15-20 mg/L

Frequency depends on renal function

View vancomycin nomogram

Duration of Therapy

Treat for a minimum of 2 weeks after first negative blood culture if patient has no complicating factors

  • Evidence of endocarditis or metastatic infection

  • Presence of prostheses

  • Persistent fever 72 hours after antibiotic initiation

  • Persistent S.aureus bacteremia 4 days after appropriate antibiotic initiation

Longer treatment duration is needed for patients who have complicated S.aureus bacteremia to prevent relapse

Monitoring