Recommendations
| Dosage | Remarks | |
|---|---|---|
|
1st choice
|
flucloxacillin IV loading dose 1 g, 6 g continuous per 24 hours
+ rifampicin oral 450 mg twice daily |
If continuous infusion is not possible, give flucloxacillin 1 g six times daily. In case of sepsis and/or immunosuppression and/or known valvular abnormality or prosthetic valve: give flucloxacillin IV loading dose 2 g, 12 g continuous per 24 hours because of the risk of endocarditis. Reduce the dose to 6 g per 24 hours if there is no bacteraemia.
|
|
2nd choice
|
cefazolin IV loading dose 1 g, 6 g continuous per 24 hours
+ rifampicin oral 450 mg twice daily |
If continuous infusion is not possible, give cefazolin 2 g three times daily.
|
| Dosage | Remarks | |
|---|---|---|
|
1st choice
|
clindamycin oral 600 mg three times daily
+ rifampicin oral 450 mg twice daily |
|
|
2nd choice
|
cotrimoxazole (trimethoprim + sulfamethoxazole) oral 800/160 mg twice daily
+ rifampicin oral 450 mg twice daily |
If cotrimoxazole is contraindicated: levofloxacin 500 mg twice daily |
Add rifampicin only in DAIR or 1-stage exchange. Not in 2-stage exchange or chronic therapy.
Add rifampicin as soon as staphylococci have been detected. If these prove resistant to rifampicin, discontinue rifampicin.
Reduce the dose of rifampicin to 300 mg twice daily in case of adverse effects.