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IDSA Vertebral Osteomyelitis

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Microorganisms Causing NVO Alternatives a Comments d • Vancomycin IV 15-20 mg/kg q12h c OR • Daptomycin 6-8 mg/kg IV q24h OR • Linezolid 600 mg PO/IV q12h OR • Levofloxacin PO 500-750 mg PO q24h and rifampin PO 600 mg daily OR • Clindamycin IV 600-900 mg q8h 6 weeks duration • Daptomycin 6-8 mg/kg IV q24h OR • Linezolid 600 mg PO/IV q12h OR • Levofloxacin PO 500-750 mg PO q24h and rifampin PO 600 mg daily 6 weeks duration • Vancomycin 15-20 mg/kg IV q12h (consider loading dose, monitor serum levels) OR • Daptomycin 6 mg/kg IV q24h OR • Linezolid 600 mg PO Or IV q12h Recommend the addition of 4-6 weeks of aminoglycoside therapy in patients with infective endocarditis. In patients with bloodstream infection physicians may opt for a shorter duration of therapy. Optional for other patients. Vancomycin should be used only in case of penicillin allerg y. • Daptomycin 6 mg IV q24h OR • Linezolid 600 mg PO or IV q12h Recommend the addition of 4-6 weeks of aminoglycoside therapy in patients with infective endocarditis. In patients with bloodstream infection physicians may opt for a shorter duration of aminoglycoside. e additional of aminoglycoside is optional for other patients. • Ciprofloxacin 750 mg PO q12h (or 400 mg IV q8h) OR • Aztreonam 2 g IV q8h for severe penicillin allerg y and quinolones resistant strains OR • Ceftazidime 2g IV q8h • 6 weeks duration • Double coverage may be considered (i.e., Beta lactam and ciprofloxacin or beta lactam and an aminoglycoside) • Ciprofloxacin 500 -750 mg PO q12h or 400 mg IV q12h 6 weeks duration • Vancomycin IV 15-20 mg/kg q12h consider loading dose, monitor serum levels) • 6 weeks duration • Vancomycin only in case of allerg y • Clindamycin 600-900 mg IV q8h OR • Vancomycin IV 15-20 mg/kg q12h (consider loading dose, monitor serum levels) • 6 weeks duration • Vancomycin only in case of allerg y • Ceftriaxone 2 g IV q24h (if nalidixic acid resistant ) 6-8 weeks duration should be chosen based on in vitro susceptibility as well as patient allergies, intolerances and potential drug

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