25mg/kg IV LOAD, then maintenance dose based on CrCl (see vancomycin monitoring) (target trough = 15-20mg/L)
OR
PLUS EITHER (OPTIONAL)
OR
May give if non-anaphylactic penicillin allergy
When calculating the duration of antimicrobial therapy day 1 of therapy is the day where a documented negative blood culture is obtained
Note: A single blood culture may not be sufficient to demonstrate resolution of bacteremia (typically 2 blood cultures are to be collected and both are negative)
Uncomplicated Bacteremia: Minimum of 14 days of therapy from first negative culture
Complicated Bacteremia: Minimum 28 days (4-6 weeks) from first negative culture, and tailor duration according to focus of infection and clinical progression