Spectrum: Local Antimicrobial Stewardship, for Eastern Health

PVE Tx MRSA

Consults

Consult Infectious Diseases

S. aureus infections of prosthetic valves frequently require surgical intervention for cure - Consult Cardiovascular Surgery

Duration

MRSA 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 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