Aortitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Antimicrobial therapy is indicated in infectious aortitis. The preferred regimen includes either Cefotaxime, Ciprofloxacin, Penicillins, or Vancomycin.

Treatment

Antimicrobial Regimen

• Infectious aortitis

• Preferred regimen(1): Cefotaxime sodium 1.0 to 2.0 g IV qd
• Preferred regimen (2): Ciprofloxacin hydrochloride 400 mg IV q12h OR Ciprofloxacin hydrochloride 500 to 750 mg PO q12h OR Levofloxacin 250 to 750 mg IV/PO qd
• Preferred regimen (3): Oxacillin 1.0 to 2.0g IV or IM q4h / q6h OR Nafcillin 1.0 to 2.0 g IV or IM q4h / q6h OR Dicloxacillin 500 mg to 1.0 g IV or IM q4h /q6h
• Preferred regimen (4): Vancomycin 1.0 g (15 mg/kg, up to 3.0 to 4.0 g/d) IV q12h
• Note: Antimicrobial treatments are most effective when bactericidal, broadspectrum antibiotics are begun after obtaining blood cultures and prior to surgery. Dose of Cefotaxime sodium should be decreased by 50% in those with a creatinine clearance (CCr) of ≤ 20 mL/min. Ciprofloxacin should be used cautiously in those with a CCr ≤ 50 mL/min or when given concomitantly with drugs whose metabolism may be altered.