Endocarditis, kunstklep - S. aureus en coagulase negatieve staphylokok (CNS)
Advices
| Priority | Medication | Remarks |
|---|---|---|
|
Medication: flucloxacilline iv loading dose 2000g, 12g continuous per 24 hours 6 weeks +
gentamicine iv 3mg/kg 1dd 2 weeks +
rifampicine iv 600mg 2dd 6 weeks |
| Priority | Medication | Remarks |
|---|---|---|
|
Priority: 1st choice |
Medication: cefazoline iv 2g 3dd 6 weeks +
gentamicine iv 3mg/kg 1dd 2 weeks +
rifampicine iv 600mg 2dd 6 weeks |
Remarks:
Alternatief voor cefazoline: cefazoline 6g continue per 24 uur, opladen met 2g |
|
Priority: 1st choice |
Medication: vancomycine iv loading dose 20mg/kg, 40mg/kg continuous per 24 hours 6 weeks +
gentamicine iv 3mg/kg 1dd 2 weeks +
rifampicine iv 600mg 2dd 6 weeks |
Remarks:
Indien ernstige beta-lactam allergie of flucloxacilline ongevoelige stam Maximale oplaaddosis vancomycine: 1500 mg Alternatief vancomycine: 20 mg/kg 2 dd, oplaaddosis 30 mg/kg tot een maximum van 1500 mg |
Sources
TDM Alert
Antimicrobial resources
The following antimicrobial agents have been used in these recommendations:
External antimicrobial resources
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Metadata
Swab vid: G-205280.5
Updated: 04/14/2023 - 12:36
Status: Published
General comments
Pas de dosering van gentamicine aan op geleide van spiegels. Stop gentamicine bij tekenen van toxiciteit.
Start rifampicine op dag 3 van adequate therapie en/of indien de herhalingsbloedkweken negatief zijn.