Native valve (non-Injection Drug Users)
- Tailor antibiotic therapy to C&S results. β-lactams superior to vancomycin so preferred if susceptible. If penicillin allergy reported, allergy should be confirmed by an allergist and desensitization considered.
Usual Pathogens
S. aureus/MRSA
Viridans Group Streptococci
Enterococcus spp
HACEK organisms
Coagulase negative Staphylococci
Streptococcus gallolyticus (S. bovis biotype 1)
Abiotrophia spp
Granulicatella spp
Gemella spp
Rare:
S. pneumoniae
S. pyogenes (Group A)
S. agalactiae (Group B)
ß-haemolytic Streptococci group C&G
Enterobacterales
Neisseria spp
Moraxella spp
| Empiric Therapy | Duration | |
|---|---|---|
| Vancomycin | 15mg/kg IV q8-12h | Culture negative - see Blood Culture-Negative Endocarditis. Culture positive - see Recommended Therapy of Culture-Directed Infections. |
| + | ||
| Ceftriaxone | 2g IV daily |
Severe penicillin/cephalosporin allergy
| Empiric Therapy | Duration | |
|---|---|---|
| Vancomycin | 15mg/kg IV q8-12h | Culture negative - see Blood Culture-Negative Endocarditis. Culture positive - see Recommneded Therapy of Culture-Directed Infections. |
| + | ||
| 3mg/kg IV daily |