Деякі схеми застосування антибіотиків при ендокардиті у Сполучених Штатах Америки*

Streptococci susceptible to penicillin (penicillin G MIC ≤ 0.1 mcg/mL)

For NVE: Penicillin G 12–18 million units a day IV continuously or 2–3 million units every 4 hours for 4 weeks or, if gentamicin 3 mg/kg† IV or IM once a day is given concurrently, for 2 weeks

For PVE: Penicillin G 24 million units a day IV continuously or 4 million units every 4 hours for 6 weeks or, if gentamicin 3 mg/kg† IV or IM (up to 80 mg) is given concurrently, for 2 weeks

Ceftriaxone 2 g IV or IM once a day for 4 weeks for NVE (6 weeks for PVE) or, if gentamicin 3 mg/kg† IV or IM once a day is given concurrently, for 2 weeks if there is no history of penicillin anaphylaxis

or

Vancomycin‡ 15 mg/kg IV every 12 hours for 4 weeks for NVE (6 weeks for PVE)

Streptococci resistant to penicillin (penicillin G MIC > 0.1 mcg/mL)

For NVE: Gentamicin 3 mg/kg† IV or IM once a day for 2 weeks plus penicillin G 24 million units/ a day IV continuously or 4 million units every 4 hours for 4 weeks

For PVE: Gentamicin 3 mg/kg† IV or IM once a day for 2 weeks plus penicillin G 24 million units a day IV continuously or 4 million units every 4 hours or ceftriaxone 2 g once a day IV or IM for 6 weeks

Vancomycin‡ 15 mg/kg IV every 12 hours for 4 weeks for NVE (6 weeks for PVE)

Enterococci

For NVE and PVE: Ampicillin 2 g IV every 4 hours plus ceftriaxone 2 g IV every 12 hours for 6 weeks

For NVE and PVE: Vancomycin 15 mg/kg IV every 12 hours plus gentamicin 3 mg/kg IV or IM once a day or gentamicin 1 mg/kg IV or IM every 8 hours for 6 weeks

or

For NVE and PVE: Linezolid 600 mg orally or IV every 12 hours for 6–8 weeks

or

For NVE and PVE: Daptomycin 10–12 mg/kg IV once a day for 6–8 weeks

Staphylococci susceptible to oxacillin

For NVE: Oxacillin or nafcillin 2 g IV every 4 hours for 6 weeks

For PVE: Oxacillin or nafcillin 2 g IV every 4 hours for 6–8 weeks plus gentamicin 1 mg/kg† IV every 8 hours for 2 weeks plus rifampin 300 mg IV or orally every 8 hours for 6–8 weeks

NVE: Cefazolin 2 g IV every 8 hours for 6 weeks if there is no history of penicillin anaphylaxis (6–8 weeks for PVE)

or

Vancomycin‡ 15 mg/kg IV every 12 hours for 4 weeks for NVE (6–8 weeks for PVE)

or

For right-sided NVE: Daptomycin 6 mg/kg IV once a day for 6 weeks

Staphylococci resistant to oxacillin

For NVE: Vancomycin† 15 mg/kg IV every 12 hours alone for 6 weeks

For PVE: Vancomycin‡ 15 mg/kg IV every 12 hours for 6–8 weeks, plus gentamicin 1 mg/kg IV† every 8 hours for 2 weeks plus rifampin 300 mg orally every 8 hours for 6–8 weeks for PVE

or

For right-sided NVE: Daptomycin 6 mg/kg IV once a day for 6 weeks

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HACEK microorganisms§

Ceftriaxone 2 g once/day IV or IM for 4 weeks for NVE (6 weeks for PVE)

or

Ampicillin 2 g IV every 4 hours for 4 weeks for NVE (6 weeks for PVE)

or

Ciprofloxacin 1000 mg orally once a day or 400 mg IV every 12 hours for 4 weeks for NVE (6 weeks for PVE)

Ceftriaxone 2 g IV once a day for 4 weeks for NVE (6 weeks for PVE) if there is no history of penicillin anaphylaxis

Noncoliform bacilli

Sensitivity-proven beta-lactam antimicrobial (eg, ceftriaxone 2 g IV every 12–24 hours or ceftazidime 2 g IV every 8 hours) plus an aminoglycoside (eg, gentamicin 2 mg/kg† IV every 8 hours) for 6 weeks

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