Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Staphylococcal - Prosthetic - Susceptible

Duration

At least 6 weeks

Gentamicin should only be added for the first two weeks of treatment.

Antibiotic Regimen

Cloxacillin 2 g IV q4h

PLUS

Rifampin 300 mg PO q8h

PLUS

Gentamicin 1 mg/kg IV q8h

Added for the first two weeks of therapy

Should not be administered to patients with CrCl under 30 mL/min.

Beta-lactam anaphylaxis

Vancomycin 15-20 mg/kg IV q8-12h

Dose should be adjusted to obtain serum trough levels of 15-20 mg/L. Peak levels are not routinely indicated.

Beta-lactam allergy (non-anaphylactic)

Cefazolin may be substituted for cloxacillin in the regimen above

Cefazolin 2 g IV q8h