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Bacteremia - Central Line Associated
Enterococcus Species

Enterococcus Species

Empiric Regimen

Vancomycin 25 mg/kg IV load, then 15 mg/kg IV Q12H or as per vancomycin initiation order set
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  • Order set link found in vancomycin monograph
  • Notify pharmacist for levels and further dosing

Once Susceptibilities Known

Ampicillin 2 g IV Q4H
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1st line, if susceptible and no allergy

OR

Vancomycin continue as per pharmacist and trough levels
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2nd line, if allergy or resistance

Vancomycin Resistant Enterococci (VRE)

OR

Clinical Considerations

Duration:

  • Uncomplicated (removable source): minimum 2 weeks from first negative blood culture
  • Complicated (e.g. endocarditis, osteomyelitis, unremovable source or bacteremia that persists more than 72 hours on appropriate therapy): requires 6 weeks of therapy