Table 5.
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.