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Guidelines
Pathogens
Antimicrobials
Infectious Diseases Consultation is recommended for all S. aureus bacteremias
Clinical Evaluation
Blood Cultures
Echocardiography
Uncomplicated Bacteremia
Positive blood culture results and all of the following:
Intravascular catheter source of infection (if present) removed within 5 days
Negative follow-up blood cultures 24-72 hours after initial positive culture
Defervescence within 72 hours of initial positive culture
Echocardiogram without evidence of endocarditis
No symptoms or signs of metastatic infection
No indwelling intravascular prosthetic devices
Complicated Bacteremia
Positive follow-up blood culture for S. aureus, OR
Persistent fever, OR
Echocardiography with evidence of endocarditis, OR
Symptoms or signs of metastatic infection
Adults
Penicillin Allergy
Children
Neonates
When calculating the duration of antimicrobial therapy, day 1 of therapy is the day where a documented negative blood culture is obtained.
Minimum 14 days of therapy.
Minimum 28 days, and tailor duration according to focus of infection and clinical progression.