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  • 1. Bacteremia[1]
  • 1.1 Ampicillin or Penicillin susceptible
  • 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
  • 1.3 Ampicillin and Vancomycin resistant
  • 2.1 Endocarditis in Adults
  • 2.1.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
  • Preferred regimen: (Ampicillin 12 g/day IV for 4–6weeks ORAqueous crystalline penicillin G sodium 18–30 MU/day IV for 4–6weeks) ANDGentamicin sulfate 3 mg/kg/day IV/IM for 4–6 weeks
  • Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
  • Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV for 6 weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
  • 2.1.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
  • 2.1.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
  • 2.1.3.1 β Lactamase–producing strain
  • 2.1.3.2 Intrinsic penicillin resistance
  • 2.1.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
  • 2.2 Endocarditis in Pediatrics
  • 2.2.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
  • Preferred regimen: (Ampicillin 300 mg/kg/day IV for 4–6weeks ORPenicillin 300,000 U/kg/day IV for 4–6 weeks) ANDGentamicin 3 mg/kg q24h IV/IM 4–6weeks
  • Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
  • Alternate regimen : Vancomycin 40 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
  • 2.2.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
  • 2.2.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
  • 2.2.3.1 β Lactamase–producing strain
  • 2.2.3.2 Intrinsic penicillin resistance
  • 2.2.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
  • 3. Meningitis[4]
  • 3.1 Ampicillin susceptible
  • 3.2 Ampicillin resistant
  • 3.3 Ampicillin and vancomycin resistant
  • 4. Urinary tract infections [5]
  • Preferred regimen (2): Fosfomycin 3 g PO single dose
  • Preferred regimen (3): Amoxicillin 875 mg to 1 g PO q12h for 5 days
  • 5. Intra abdominal or Wound infections [6]
  • Preferred regimen(1): Penicillin
  • Preferred regimen(2): Ampicillin
  • Alternative regimen(Penicillin allergy or high-level Penicillin resistance): Vancomycin
  • Alternative regimen(For complicated skin-skin structure and intra-abdominal infection): Tigecycline 100 mg IV single dose and 50 mg IV q12h



  • 1. Bacteremia[7]
  • 1.1 Ampicillin or Penicillin susceptible
  • 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
  • 1.3 Ampicillin and Vancomycin resistant
  • 2. Endocarditis
  • 2.1 Endocarditis in Adults [2]
  • Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
  • Preferred regimen: (Ampicillin 12 g/day IV for 4–6weeks ORAqueous crystalline penicillin G sodium 18–30 MU/day IV for 4–6weeks) ANDGentamicin sulfate 3 mg/kg/day IV/IM for 4–6 weeks
  • Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
  • Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV for 6 weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
  • 2.2.Endocarditis in Pediatrics
  • Preferred regimen : (Ampicillin 300 mg/kg/day IV for 4–6 weeks ORPenicillin 300,000U/kg/day IV for 4–6 weeks) ANDGentamicin 3 mg/kg per 24 h IV/IM 4–6 weeks
  • Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
  • Alternate regimen : Vancomycin 40 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
  • β Lactamase–producing strain
  • Preferred regimen : Ampicillin-sulbactam 300 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
  • Alternate regimen : Vancomycin 40 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
  • Intrinsic penicillin resistance : Vancomycin 40 mg/kg/day IV ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
  • 3.Meningitis[4]
  • 4.Urinary tract infections [8]


  • 5. Intra abdominal or Wound infections [9]
  • Preferred regimen(1): Penicillin
  • Preferred regimen(2): Ampicillin
  • Alternative regimen(Penicillin allergy or high-level Penicillin resistance): Vancomycin
  • Alternative regimen(For complicated skin-skin structure and intra-abdominal infection): Tigecycline 100 mg IV single dose and 50 mg IV q12h
  1. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  2. 2.0 2.1 Baddour, LM.; Wilson, WR.; Bayer, AS.; Fowler, VG.; Bolger, AF.; Levison, ME.; Ferrieri, P.; Gerber, MA.; Tani, LY. (2005). "Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America". Circulation. 111 (23): e394–434. doi:10.1161/CIRCULATIONAHA.105.165564. PMID 15956145. Unknown parameter |month= ignored (help)
  3. "Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association".
  4. 4.0 4.1 Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM; et al. (2004). "Practice guidelines for the management of bacterial meningitis". Clin Infect Dis. 39 (9): 1267–84. doi:10.1086/425368. PMID 15494903.
  5. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  6. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  7. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  8. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  9. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.