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Antimicrobials
Catheter removal recommended; if retention necessary, discuss with Infectious Diseases
Continue vancomycin until susceptibilities available. Once susceptibilities available, narrow therapy to ampicillin if susceptible
Evaluate for features of endocarditis (persistent bacteremia, prosthetic valve, murmur or embolic finding) and obtain echocardiography if suspicious
IF VRE colonized, consider linezolid or daptomycin pending susceptibilities
Linezolid 600mg PO/IV q12h Daptomycin 6-10mg/kg IV daily
If E. faecalis, use Ampicillin 2g IV q4-6h empirically, based on 100% susceptibility in Newfoundland and Labrador
If E. faecium, use Vancomycin
Vancomycin IV loading dose followed by maintenance for target trough of 15-20 ug/mL see dosing nomogram
If patient cannot be dosed using nomogram contact Pharmacy.
Duration of therapy for uncomplicated disease 7-14 days
