Native valve endocarditis caused by methicillin-resistant staphylococci
For native valve endocarditis caused by methicillin-resistant staphylococci in adults and children, use:
vancomycin intravenously for 6 weeks; for initial dosing, see Intermittent vancomycin dosing for noncritically ill adults or Intermittent vancomycin dosing for young infants and children. vancomycin vancomycin vancomycin
For patients who do not respond to therapy and are unable to have surgery, combination therapy may be necessary – seek expert advice.
The addition of gentamicin to the treatment regimen for native valve endocarditis is not necessary since it has not been shown to improve outcomes and may be associated with toxicity.
Experience is limited in the treatment of endocarditis caused by Staphylococcus aureus with reduced susceptibility to vancomycin (vancomycin-intermediate S. aureus [VISA]) or high-level resistance to vancomycin (vancomycin-resistant S. aureus [VRSA]). Treatment options include daptomycin or linezolid – seek expert adviceMunoz, 2021.