S. pneumoniae

- Early surgical intervention often required.

Penicillin MIC ≤ 0.12µg/mL

Therapy Dose Duration
    Native Prosthetic
Penicillin 3MU IV q4h 4 weeks 6 weeks
or      
Ceftriaxone 2g IV daily 4 weeks 6 weeks

Penicillin MIC > 0.12 - 2.0µg/mL

Therapy Dose Duration
    Native Prosthetic
Ceftriaxone 2g IV daily 4 weeks 6 weeks

Ceftriaxone MIC ≥ 2.0µg/mL

Therapy Dose Duration
    Native Prosthetic
Ceftriaxone 2g IV daily 4 weeks 6 weeks
+      
Vancomycin 15mg/kg IV q8-12h 4 weeks 6 weeks
+      
Rifampin 300mg PO bid 4 weeks 6 weeks

Severe penicillin/cephalosporin allergy

Therapy Dose Duration
    Native Prosthetic
Vancomycin 15mg/kg IV q8-12h 4 weeks 6 weeks