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Enterococcus spp

Amp S, Gent synergy S

Therapy	Dose	Duration
[Ampicillin	2g IV q4h	6 weeks
+
Gentamicin]	3mg/kg IV daily	2 weeks
or
[Ampicillin	2g IV q4h	6 weeks
+
Ceftriaxone]	2g IV q12h	6 weeks

Amp S, Gent synergy R, Strep synergy S

Therapy	Dose	Duration
[Ampicillin	2g IV q4h	6 weeks
+
Ceftriaxone]	2g IV q12h	6 weeks
or
[Ampicillin	2g IV q4h	4 weeks
+
Streptomycin]	7.5mg/kg IV/IM q12h	4 weeks

Amp S, Gent/Strep synergy R

Therapy	Dose	Duration
[Ampicillin	2g IV q4h	6 weeks
+
Ceftriaxone]	2g IV q12h	6 weeks
or
Ampicillin	3g IV q4h	8-12 weeks

Amp R, Gent synergy S - high level ampicillin resistance MIC > 128µg/mL

Therapy	Dose	Duration
Vancomycin	15mg/kg IV q8-12h	6 weeks
+
Gentamicin	3mg/kg IV daily	2 weeks

Amp R, Gent synergy S - low level ampicillin resistance MIC 16-64µg/mL

Therapy	Dose	Duration
[Vancomycin	15mg/kg IV q8-12h	6 weeks
+
Gentamicin]	3mg/kg IV daily	2 weeks
or
[Ampicillin	3g IV q4h	≥ 6 weeks
+
Gentamicin]	3mg/kg IV daily	2 weeks

Amp R, Vanco R MIC > 4µg/mL, Gent/Strep synergy R

Consult Infectious Diseases.

Therapy	Dose	Duration
Daptomycin	10-12mg/kg IV daily	≥ 8 weeks
+
Ampicillin	2g IV q4h	≥ 8 weeks