Guidelines For The Empirical Treatment Of Sepsis In Adults

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Antibiotic Guideline for the Treatment of Endocarditis:

++All therapy and investigation should be discussed with Microbiology / Infectious Diseases.++

- If penicillin allergic click here.

Staphylococcus Aureus

Penicillin resistant, meticillin sensitive

Flucloxacillin 2 g every four hours for four weeks^* if native valve or 6 weeks if prosthetic heart valve plus Gentamicin IV 80–120 mg TDS (monitor levels) for 5 days.

*If treating an injecting drug user with right native heart valve infection, a shorter course may be sufficient- discuss with Microbiology.

Penicillin and meticillin resistant (MRSA)

Vancomycin IV 1 g BD (adjust dose if >65 yrs or renal impairment; monitor levels) for four weeks* plus a second agent on microbiology advice according to sensitivities (either Gentamicin IV 80–120 mg TDS for 5 days or Rifampicin PO 300-600mg BD for 4 weeks* or Sodium fusidate PO 500mg TDS for 4 weeks*)

* Give six weeks therapy if treating prosthetic valve endocarditis.

Staphylococcus epidermidis

Therapy as for MRSA above but always given for six weeks.

Page last edited: 31/10/2008

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.