Selecting a Treatment Regimen Table 1. Recommendations for the Treatment of MRSA Treatments Manifestation
Management/ Surgery
Bacteremia and Infective Endocarditis Bacteremia||
A clinical assessment to identify the source and extent of the infection with elimination and/ or debridement of other sites of infection should be conducted (A-II). Echocardiography is recommended for all adult patients with bacteremia. Transesophageal echocardiography (TEE) is preferred over transthoracic echocardiography (TTE).
Vancomycin‡§
Daptomycin‡ (Cubicin®
)
15-20 mg/kg/dose IV q8-12h
6 mg/kg/dose IV daily
Duration of Therapy Antibiotics Agent Adult Dose
Treat for 2-6 weeks.†
Persistent bacteremia Please see Persistent MRSA Bacteremia and Vancomycin Treatment Failures in Adults (page 15)
Infective endocarditis, native valve
Infective endocarditis, prosthetic valve
Repeat blood cultures 2-4 days aſter initial positive cultures and as needed thereaſter are recommended to document clearance of bacteremia.
Treat for 6 weeks.
Same as for bacteremia
Vancomycinठand
Treat for ≥ 6 weeks plus gentamicin for 2 weeks.
† Based on the extent of disease and the patient's clinical response. ‡ Adjust dose for renal impairment – see Prescribing Information for renal dosing.
Gentamicin‡ and
Rifampin
15-20 mg/kg/dose IV q8-12h
1 mg/kg/dose IV q8h
300 mg PO/IV q8h
6
(cont'd)
(Br
and)
