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. 2018 Jul 12;2018:6278012. doi: 10.1155/2018/6278012

Table 5.

Antimicrobial treatment in CN PJI [23].

Microorganism Antibiotic a Dose b Route
(red: difficult-to-treat) (check pathogen susceptibility before) (italic font: renal adjustment needed)
Culture-negative Ampicillin/sulbactamc 3 × 3 g i.v.
for 2 weeks, followed by:
Rifampind + Levofloxacin 2 × 450 mg p.o.
2 × 500 mg p.o.

a Total duration of therapy: 12 weeks, usually 2 weeks intravenously, followed by oral route.

bLaboratory testing 2x weekly: leukocytes, CRP, creatinine/eGFR, liver enzymes (AST/SGOT and ALT/SGPT). Dose-adjustment according to renal function and body weight (<40/> 100kg).

c Penicillin allergy of NON-type 1 (e.g., skin rash): cefazolin (3 × 2 g i.v.). In case of anaphylaxis (= type 1 allergy such as Quincke's edema, bronchospasm, and anaphylactic shock) or cephalosporin allergy, vancomycin (2 × 1 g i.v.) or daptomycin (1 × 8 mg/kg i.v.).

Ampicillin/sulbactam is equivalent to amoxicillin/clavulanic acid (3 × 2.2 g i.v.).

d Rifampin is administered only after the new prosthesis is implanted. Add it already to intravenous treatment as soon as wounds are dry and drains removed; in patients aged >75 years, rifampin is reduced to 2 × 300 mg p.o.