Injection Drug Users (right-sided)
- 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
P. aeruginosa
Enterobacteriaceae, especially Serratia
Candida spp
Enterococcus spp
Viridans Group Streptococci
Polymicrobial
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 15mg/kg IV q8-12h | Culture negative - see Blood Culture-Negative Endocarditis. Culture positive - see Recommended Therapy of Culture-Directed Infections. |
| +/- | ||
| [Gentamicin | 1.5-2mg/kg IV q8h | |
| or | ||
| Tobramycin | 1.5-2mg/kg IV q8h | |
| or | ||
| Ciprofloxacin] | 400mg IV q12h/750mg PO bid |