Post-operative - mediastinitis / sternotomy
- All require surgical debridement of the sternum and mediastinum for therapy and C&S.
Usual Pathogens
S. aureus
Enterobacterales
Coagulase negative Staph
Occasionally:
Candida spp
P. aeruginosa
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cefazolin (pending cultures) | 100mg/kg/d IV div q8h | ≥ 4 weeks |
| + | ||
| Gentamicin | 7mg/kg IV q24h |
Severely ill
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Piperacillin-tazobactam | 240-300mg piperacillin/kg/d IV div q6-8h | ≥ 4 weeks |
| +/- | ||
| Tobramycin | 7mg/kg IV q24h |
MRSA colonized
Add Vancomycin to above regimens
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 60mg/kg/d IV div q6h |