Firstline - Clinical Decisions

Initial Empiric Treatment

Vancomycin 25-30 mg/kg IV loading dose

Subsequent dosing frequency depends on renal function.

View vancomycin nomogram

Duration of Therapy

Short duration of therapy of two weeks (from the first negative blood culture) should only be provided to patients meeting all of the following criteria for uncomplicated Staphylococcus aureus bacteremia.

Infective endocarditis has been excluded
No implanted prostheses are present
Follow up blood cultures drawn 2-4 days after the initial set are sterile
The patient defervesces within 72 hours of initiation of effective antibiotic therapy
No evidence of metastatic infection is present on examination

Monitoring

Identification of Staphylococcus aureus

Initial Empiric Treatment

Duration of Therapy