Staph. aureus Bacteremia
MSSA Bacteremia

MSSA Bacteremia

Note

Perform allergy assessment if required, in order to use first line antimicrobial

Treatment - Start Immediately

OR

AND

STOP Vancomycin

Management

Repeat blood culture on day 2

Remove indwelling catheters

  • For patients with prosthetic valves obtain a TTE
  • If TTE is negative, obtain a TEE in patients whose fever and bacteremia does not resolve in 72 hours, OR if patient is on hemodialysis, has non-vertebral osteomyelitis, spinal infection, metastatic foci or no obvious source of bacteremia
  • If TTE is poor quality, discuss need for TEE with cardiology
  • Endocarditis
  • Septic arthritis
  • Osteomyelitis
  • Discitis
  • Thrombophlebitis

Duration of Therapy

4 weeks (if there is no disseminated infection) from first documented negative blood culture and resolution of symptoms

Insert PICC line once blood cultures are negative, as appropriate or required for outpatient therapy

Oral therapy is not appropriate