Spectrum: Local Antimicrobial Stewardship, for Eastern Health

PVE Tx CoNS (Clox R)

Duration of Therapy

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

Suggested Regimen

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.

AND

Rifampin 300mg PO q8h x SIX weeks

Multiple drug interactions; consult Pharmacy

AND

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