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In patients with PVE due to methicillin-susceptible staphylococci, (flu)cloxacillin or cefazolin with rifampin for at least 6 weeks and gentamicin for 2 weeks is recommended using the following doses:

I B

Adult antibiotic dosage and route

(Flu)cloxacillin 12 g/day i.v. in 4–6 doses Cefazolin 6 g/day i.v. in 3 doses Rifampin 900 mg/day i.v. or orally in 3 equally divided doses Gentamicin 3 mg/kg/day i.v. or i.m. in 1 (preferred) or 2 doses Paediatric antibiotic dosage and route

(Flu)cloxacillin 200–300 mg/kg/day i.v. in 4–6 equally divided doses Cefazolin 100 mg/kg/day i.v. in 3–4 doses, up to maximum of 6 g/day Rifampin 20 mg/kg/day i.v. or orally in 3 equally divided doses up to maximum of 900 mg/day Gentamicin 3 mg/kg/day i.v. or i.m. in 1 (preferred) or 2 doses Allergy to beta-lactams In patients with NVE due to methicillin-susceptible staphylococci who are allergic to penicillin, cefazolin for 4–6 weeks is recommended using the following doses: I B Adult antibiotic dosage and route

Cefazolin 6 g/day i.v. in 3 doses Paediatric antibiotic dosage and route

Cefazolin 100 mg/kg/day i.v. in 3–4 doses, up to maximum of 6 g/day In patients with PVE due to methicillin-susceptible staphylococci who are allergic to penicillin, cefazolin combined with rifampin for at least 6 weeks and gentamicin for 2 weeks is recommended using the following doses:

I B

Adult antibiotic dosage and route

Cefazolin 6 g/day i.v. in 3 doses Rifampin 900 mg/day i.v. or orally in 3 equally divided doses Gentamicin 3 mg/kg/day i.v. or i.m. in 1 (preferred) or 2 doses Paediatric antibiotic dosage and route

Cefazolin 100 mg/kg/day i.v. in 3–4 doses, up to maximum of 6 g/day Rifampin 20 mg/kg/day i.v. or orally in 3 equally divided doses up to maximum of 900 mg/day Gentamicin 3 mg/kg/day i.v. or i.m. in 1 (preferred) or 2 doses IE caused by methicillin-resistant staphylococci In patients with NVE due to methicillin-resistant staphylococci, vancomycin is recommended for 4–6 weeks using the following doses: I B Adult antibiotic dosage and route

Vancomycin 30–60 mg/kg/day i.v. in 2–3 doses Paediatric antibiotic dosage and route

Vancomycin 30 mg/kg/day i.v. in 2–3 equally divided doses In patients with PVE due to methicillin-resistant staphylococci, vancomycin with rifampin for at least 6 weeks and gentamicin for 2 weeks is recommended using the following doses:

I B

Adult antibiotic dosage and route

Vancomycin 30–60 mg/kg/day i.v. in 2–3 doses Rifampin 900–1200 mg/day i.v. or orally in 2 or 3 divided doses Gentamicin 3 mg/kg/day i.v. or i.m. in 1 (preferred) or 2 doses Paediatric antibiotic dosage and route

Vancomycin 30 mg/kg/day i.v. in 2–3 equally divided doses Rifampin 20 mg/kg/day i.v. or orally in 3 equally divided doses up to maximum of 900 mg/day Gentamicin 3 mg/kg/day i.v. or i.m. in 1 (preferred) or 2 doses Recommendations for antibiotic treatment of infective endocarditis due to Enterococcus spp. Beta-lactam and gentamicin-susceptible strains In patients with NVE due to non-HLAR Enterococcus spp., the combination of ampicillin or amoxicillin with ceftriaxone for 6 weeks or with gentamicin for 2 weeks is recommended using the following doses: I B Adult antibiotic dosage and route

Amoxicillin 12 g/day i.v. in 4–6 doses Ampicillin 12 g/day i.v. in 4–6 doses

Continued

ESC Guidelines                                                                                                                                                                                          4017

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