Cardiovascular antibiotics

Endocarditis

Native Valves

Options:

• Ampicillin/Sulbactam 12g/day IV in 4 doses + Gentamicin 3mg/kg/day IV in 2 or 3 doses
• Amoxicillin/Clavulanate 12g/day in 4 dose + Gentamicin 3mg/kg/day IV in 2 or 3 doses
• Oxacillin or Nafcillin 2g IV six times daily + Gentamicin 1mg/kg IV three times daily AND Ampicillin 2g IV six times daily
• Daptomycin 6mg/kg IV once daily

Suspected MRSA:

• Vancomycin 30mg/kg/day IV in 2 doses PLUS
• Gentamicin 3mg/kg/day IV in 2 or 3 doses PLUS
• Ciprofloxacin 1000mg/day PO in 2 doses or 800 mg/day IV in 2 doses

Prosthetic Valves (Early)

Early prosthetic valve endocarditis defined as < 12 months post surgery

• Vancomycin 30mg/kg/day IV in 2 doses PLUS
• Gentamicin 3mg/kg/day IV in 2 or 3 doses PLUS
• Rifampin 1200 mg/day PO in 2 doses

IV Drug User without Prosthetic Valve

• Vancomycin 15-20 mg/kg IV BID daily
• Daptomycin 6mg/kg IV once daily

Prosthetic Valve (Late)

Late prosthetic valve endocarditis defined as ≥ 12 months post surgery

• Same as native valve endocarditis empiric therapy

Dental Procedure Prophylaxis

All antibiotics options are given as a single dose 1 hour prior to the dental procedure

Options:

• Amoxicillin 2g or 50mg/kg
• Ampicillin 2g (50mg/kg) IV or IM
• Cefazolin or Ceftriaxone 1g (50mg/kg) IM or IV
• Clindamycin 600mg (20mg/kg) PO or IV
• Azithromycin or Clarithromycin 500mg (15mg/kg) PO

See Also

Antibiotics by diagnosis

• Bone and joint antibiotics
• Cardiovascular antibiotics
• ENT antibiotics
• Eye antibiotics
• GI antibiotics
• GU antibiotics
• Neuro antibiotics
• OB/GYN antibiotics
• Pulmonary antibiotics
• Skin and soft tissue antibiotics
• Bioterrorism antibiotics
• Environmental exposure antibiotics
• Immunocompromised antibiotics
• Post exposure prophylaxis antibiotics
• Pediatric antibiotics
• Sepsis antibiotics
• Arthropod and parasitic antibiotics

For antibiotics by organism see Microbiology (Main)

References

Authors

Ross Donaldson, Daniel Ostermayer