Adult

Infective Endocarditis Treatment

Empirical antibiotic treatment - pending blood culture results - before pathogen identification (typically for less than 48hours)

  • Micro/ID should be consulted in all cases of possible endocarditis
  • Cardiology should be consulted in all cases of confirmed endocarditis and those where there is a high clinical suspicion pending further investigation.
  • Ideally DO NOT start antibiotics until after discussion with Micro/ID.
  • Ideally, take a minimum of 3 blood culture sets (6 bottles, 8-10ml per bottle) before antibiotic administration; if possible have a gap of at least 30min between sets.
  • Antibiotic therapy should be refined based on blood culture results. 
  • True culture negative endocarditis is rare – Micro/ID will advise on-going treatment and investigation in such cases.
  • Ensure penicillin allergy is properly investigated. Consider penicillin allergy assessment and delabelling
  • Patients requiring aminoglycosides for 2 weeks or more for infective endocarditis: See Audiometry and intravenous aminoglycosides guidance. 

Community acquired native valve OR late (more than 12 months post-surgery) prosthetic valve endocarditis

Preferred:

amoxicillin 2g iv every 4 hours                                     

AND flucloxacillin 2g iv every 4 hours

AND gentamicin 3mg/kg iv od. For levels and dose adjustment see gentamicin Infective endocarditis monitoring guideline

 

For penicillin allergy (non-severe)

cefazolin 2g tds iv

AND gentamicin 3mg/kg iv od. For levels and dose adjustment see gentamicin Infective endocarditis monitoring guideline

 

For penicillin allergy (severe) OR MRSA positive patients

vancomycin iv see monograph for dosing 

AND gentamicin 3mg/kg iv od. For levels and dose adjustment see gentamicin Infective endocarditis monitoring guideline

Nosocomial/healthcare associated or early prosthetic valve (less than 12 months post-surgery) endocarditis

Including implantable cardiac electronic device-associated endocarditis

Preferred (including penicillin allergy (severe and non-severe) and MRSA positive patients

vancomycin iv see monograph for dosing

AND gentamicin 3 mg/kg iv od. For levels and dose adjustment see gentamicin Infective endocarditis monitoring guideline 

(rifampicin may be recommended by Micro/ID after 3-5 days)

Editorial Information

Last reviewed: 01 Nov 2024