Antimicrobial treatment 5

There are two important principles of management:

Treatment must be given intravenously for at least 2 weeks. Treatment is prolonged—usually 4 to 6 weeks.

Consultation with an infectious disease physician or clinical microbiologist should be sought. Once cultures have been taken, prompt empirical antimicrobial treatment should be commenced, especially in fulminating infection suspected to be endocarditis. Benzylpenicillin, gentamicin and flucloxacillin/ dicloxacillin are recommended,

• benzylpenicillin 1.8 g IV, 4 hourly plus flucloxacillin/dicloxacillin 2 g IV, 4 hourly plus gentamicin 2 mg/kg IV, 8 hourly

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