Hospitalized Adults: Endocarditis: Native Valve

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Native Valve

S. aureus

Streptococci spp.

Enterococcus spp.

Occasional gram negative rods

HACEK < 5%

Vancomycin

WITH or WITHOUT*

Ceftriaxone

2 g IV daily

For severe PCN allergy:

Vancomycin

WITH or WITHOUT*

CiprofloxacinID-R: VASF 400 mg IV q12h

ID consultation is strongly recommended regarding choice and duration of therapy

 

Narrow coverage to microbiologically confirmed pathogens

 

*Addition of Gram-negative coverage should be considered if the patient has a sub-acute presentation. 

References:

Baddour LM, Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals.... Circulation. 2005 Jun 14;111(23):e394-434.