Sandbox ID Cardiovascular

• Endocarditis

• Viridans group streptococci and Streptococcus bovis

• Native valve endocarditis caused by highly penicillin-susceptible viridans group streptococci and Streptococcus bovis (MIC ≤ 0.12 μg/mL)

• Preferred regimen: Penicillin G 12–18 million U/24 h IV either continuously or in 4 or 6 equally divided doses for 4 weeks OR Ceftriaxone 2 g/24h IV/IM in 1 dose for 4 weeks
• Alternative regimen (1): (Penicillin G 12–18 million U/24 h IV either continuously or in 6 equally divided doses for 2 weeks OR Ceftriaxone 2 g/24h IV/IM in 1 dose for 2 weeks) PLUS Gentamicin 3 mg/kg per 24h IV/IM in 1 dose for 2 weeks
• Alternative regimen (2): Vancomycin 30 mg/kg per 24 h IV in 2 equally divided doses not to exceed 2 g/24 h for 4 weeks
• Pediatric dose: Penicillin G 200,000 U/kg per 24 h IV in 4–6 equally divided doses; Ceftriaxone 100 mg/kg per 24 h IV/IM in 1 dose; Gentamicin 3 mg/kg per 24 h IV/IM in 1 dose or 3 equally divided doses; Vancomycin 40 mg/kg per 24 h IV in 2–3 equally divided doses

• Native valve endocarditis caused by relatively penicillin-resistant viridans group streptococci and Streptococcus bovis (MIC > 0.12 to ≤ 0.5 μg/mL)

• Preferred regimen (1): (Penicillin G 24 million U/24 h IV either continuously or in 4 or 6 equally divided doses for 4 weeks OR Ceftriaxone 2 g/24h IV/IM in 1 dose for 4 weeks) PLUS Gentamicin 3 mg/kg per 24h IV/IM in 1 dose for 2 weeks
• Preferred regimen (2): Vancomycin 30 mg/kg per 24 h IV in 2 equally divided doses not to exceed 2 g/24 h for 4 weeks
• Pediatric dose: Penicillin G 200,000 U/kg per 24 h IV in 4–6 equally divided doses; Ceftriaxone 100 mg/kg per 24 h IV/IM in 1 dose; Gentamicin 3 mg/kg per 24 h IV/IM in 1 dose or 3 equally divided doses; Vancomycin 40 mg/kg per 24 h IV in 2–3 equally divided doses

• Prosthetic valve endocarditis caused by highly penicillin-ausceptible viridans group streptococci and Streptococcus bovis (MIC ≤ 0.12 μg/mL)

• Preferred regimen (1): (Penicillin G 24 million U/24 h IV either continuously or in 4 or 6 equally divided doses for 6 weeks OR Ceftriaxone 2 g/24h IV/IM in 1 dose for 6 weeks) ± Gentamicin 3 mg/kg per 24h IV/IM in 1 dose for 2 weeks
• Preferred regimen (2): Vancomycin 30 mg/kg per 24 h IV in 2 equally divided doses not to exceed 2 g/24 h for 6 weeks
• Pediatric dose: Penicillin G 200,000 U/kg per 24 h IV in 4–6 equally divided doses; Ceftriaxone 100 mg/kg per 24 h IV/IM in 1 dose; Gentamicin 3 mg/kg per 24 h IV/IM in 1 dose or 3 equally divided doses; Vancomycin 40 mg/kg per 24 h IV in 2–3 equally divided doses

• Prosthetic valve endocarditis caused by relatively penicillin-resistant viridans group streptococci and Streptococcus bovis (MIC > 0.12 μg/mL)

• Preferred regimen (1): (Penicillin G 24 million U/24 h IV either continuously or in 4 or 6 equally divided doses for 6 weeks OR Ceftriaxone 2 g/24h IV/IM in 1 dose for 6 weeks) PLUS Gentamicin 3 mg/kg per 24h IV/IM in 1 dose for 2 weeks
• Preferred regimen (2): Vancomycin 30 mg/kg per 24 h IV in 2 equally divided doses not to exceed 2 g/24 h for 6 weeks
• Pediatric dose: Penicillin G 200,000 U/kg per 24 h IV in 4–6 equally divided doses; Ceftriaxone 100 mg/kg per 24 h IV/IM in 1 dose; Gentamicin 3 mg/kg per 24 h IV/IM in 1 dose or 3 equally divided doses; Vancomycin 40 mg/kg per 24 h IV in 2–3 equally divided doses

• Staphylococcus

• Native valve endocarditis caused by oxacillin-susceptible staphylococci

• (table 7)

• Native valve endocarditis caused by oxacillin-resistant staphylococci

• (table 7)

• Prosthetic valve endocarditis caused by oxacillin-susceptible staphylococci

• (table 8)

• Prosthetic valve endocarditis caused by oxacillin-resistant staphylococci

• (table 8)

• Enterococcus

• Endocarditis caused by enterococcal strains susceptible to penicillin, gentamicin, and vancomycin

• (table 9)

• Endocarditis caused by enterococcal strains susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin

• (table 10)

• Endocarditis caused by enterococcal strains resistant to penicillin and susceptible to aminoglycoside and vancomycin

• (table 11)

• Endocarditis caused by enterococcal strains resistant to penicillin, gentamicin, and vancomycin

• Enterococcus faecium

• (table 12)

• Enterococcus faecalis

• (table 12)

• HACEK organisms

• (table 13)

• Bartonella

• Suspected Bartonella endocarditis

• (table 14)

• Documented Bartonella endocarditis

• (table 14)

• Culture-negative endocarditis

• Culture-negative, native valve endocarditis

• (table 14)

• Culture-negative, prosthetic valve endocarditis (early, ≤ 1 year)

• (table 14)

• Culture-negative, prosthetic valve endocarditis (late, > 1 year)

• (table 14)

• Chlamydia

• Coxiella burnetii

• Fungi

• Candidal endocarditis
• Non-candidal endocarditis

• Gonococcus

• Gram-negative bacilli

• Legionella

• Tropheryma whipplei

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• Lyme carditis

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• Mycotic aneurysm

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• Implantable electronic device infections

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• Pericarditis

• Bacterial pericarditis
• Histoplasmosis
• Extrapulmonary tuberculosis

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• Rheumatic fever

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• Cavernous sinus thrombosis

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• Intravenous line infections

• Intravenous line infections, non-tunneled
• Intravenous line infections, tunneled

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• Septic pelvic vein thrombophlebitis

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• Suppurative phlebitis

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• Ventricular-assist device infections