Home Therapy Heart and thorax
Home Therapy Heart and thorax

endocarditis, natieve klep - stafylokokken

Advices

≥ 18 years

Indications: Flucloxacilline gevoelig
Priority Medication Remarks
Medication:

flucloxacilline iv loading dose 2g, 12g continuous per 24 hours 6 weeks
Medication:

cefazoline iv loading dose 1g, 6g continuous per 24 hours 6 weeks
Remarks:

Bij niet ernstige penicilline-allergie: 
Niet IgE-gemedieerd (type I) en
Niet Stevens-Johnson syndroom / TEN
Medication:

vancomycine iv loading dose 20mg/kg, 30mg/kg continuous per 24 hours 6 weeks
Remarks:

Bij ernstige penicilline-allergie:
IgE-gemedieerd (type I)
of Stevens-Johnson syndroom / TEN

Zo mogelijk desensibilisatie  voor penicilline/ flucloxacilline  (bij voorkeur op de IC) in overleg met 
allergoloog en consulent infectieziekten

Vancomycine continue-dosering op geleide van TDM,
zie Opmerkingen
≥ 18 years

Indications: Flucloxacilline resistent (MRSA)
Priority Medication Remarks
Medication:

vancomycine iv loading dose 20mg/kg, 30mg/kg continuous per 24 hours 6 weeks
Remarks:

Vancomycine continue-dosering op geleide van TDM,
zie Opmerkingen

General comments

Methicilline (flucloxacilline) gevoelig: Staphylococcus aureus = MSSA of coagulase-negatieve stafylokokken = MSSE;
Methicilline (flucloxacilline) resistent: Staphylococcus aureus = MRSA of coagulase-negatieve stafylokokken = MRSE

  • Oplaaddosering vancomycine afronden naar boven (in stappen van 250 mg)
  • Opladen vancomycine: inlooptijd 2 uur !
  • Eerste vancomycine spiegel op dag 2 (streefwaarde: 20-25 mg/L)

Overleg met endocarditis-team (internist-infectioloog of arts-microbioloog)

Advies ongewijzigd gepubliceerd na beoordeling in kader van revisie SWABID UMCG in opdracht van CAM 1-8-2022

Sources

  1. SWAB Richtlijn Infectieuze Endocarditis
  2. Endocarditis protocol UMCG
  3. European Society of Cardiology (ESC): Infective Endocarditis (Guidelines on Prevention, Diagnosis and Treatment of)
  4. Pubmed.gov publication # 19713420

    Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009 Oct;30(19):2369-413.

  5. Pubmed.gov publication # 22086858

    Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults: a report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother. 2012 Feb;67(2):269-89.

Antimicrobial resources

The following antimicrobial agents have been used in these recommendations:

External antimicrobial resources
Menu position
Metadata

Swab vid: G-211127.18
Updated: 11/30/2022 - 13:14
Status: Published