ß-haemolytic Streptococci

- Early surgical intervention improves survival.

S. pyogenes (Group A)

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

S. agalactiae (Group B), Streptococcus Group C,G

Therapy Dose Duration
    Native Prosthetic
[Penicillin 4MU IV q4h 4-6 weeks 6 weeks
+      
Gentamicin] 3mg/kg IV daily or 2 weeks 2 weeks
  1mg/kg IV q8h    
or      
[Ceftriaxone 2g IV daily 4-6 weeks 6 weeks
+      
Gentamicin] 3mg/kg IV daily or 2 weeks 2 weeks
  1mg/kg IV q8h    

Severe penicillin/cephalosporin allergy

Therapy Dose Duration
    Native Prosthetic
Vancomycin 15mg/kg IV q8-12h 4 weeks (4-6 weeks for Group B,C,G) 6 weeks