Treatment regimens for adults allergic to the penicillins
| Viridans streptococci, Strep bovis, and enterococci |
|---|
| Initially either vancomycin 1 g by intravenous infusion given over at least 100 minutes twice daily. Determine blood concentrations and adjust dose to achieve one hour postinfusion concentrations of about 30 mg/l and trough concentrations of 5–10 mg/l or teicoplanin 400 mg by intravenous bolus injection 12 hourly for three doses and then a maintenance intravenous dose of 400 mg daily |
| Give vancomycin or teicoplanin for four weeks plus intravenous gentamicin 80 mg twice daily. Viridans streptococcal and Strep bovis endocarditis should be treated with gentamicin for two weeks and enterococcal endocarditis for four weeks3-150 |
| Staphylococci |
| Vancomycin initially 1g by intravenous infusion given over at least 100 minutes twice daily Blood concentrations should be monitored as above. Give for four weeks plus intravenous gentamicin 80–120 mg three times daily for one week3-150 |
↵3-150 Gentamicin blood levels must be monitored.