S. aureus
- Rule out endocarditis, unless related to recent neurosurgical procedure.
- If medical device-associated meningitis/ventriculitis and prosthetic material (e.g. CSF shunt or drain) still in place, add rifampin if isolate is susceptible.
Cloxacillin sensitive (MSSA)
| Therapy | Duration | |
|---|---|---|
| Cloxacillin | 2g IV q4h | 14 days |
ß-lactam allergy
| Therapy | Duration | |
|---|---|---|
| Vancomycin | 15mg/kg IV q8-12h |
Cloxacillin resistant (MRSA)
| Therapy | Dose | Duration |
|---|---|---|
| 15mg/kg IV q8-12h | ||
| +/- | ||
| Rifampin | 600mg IV/PO daily |
Alternative
| Therapy | Duration | |
|---|---|---|
| TMP/SMX | 15-20mg TMP/kg/day IV div q6-8h | |
| or | ||
| Linezolid | 600mg IV/PO q12h |