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India Antibiotic Guideline for Cardiovascular Infections


India Antibiotic Guideline for Cardiovascular Infections

In 2016 National Centre For Disease Control, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India came out with National Treatment Guidelines for Antimicrobial Use in Infectious Diseases.

Following are major recommendation

Cardiovascular Infections:

Condition Likely causative Organism Empiric antibiotics (presumptive antibiotics) Alternative antibiotics Comments
Infective Endocarditis:

Native valve (awaiting cultures) Indolent

Viridans Streptococci, other Streptococci, Enterococci Penicillin G 20MU IV divided doses, 4 hourly

or

Ampicillin 2gm iv 4h AND

Gentamicin 1mg/kg im or iv 8h

Duration: 4-6 weeks

Vancomycin 15mg/kg IV 12 hourly (maximum 1g 12 hourly)//teicplani n 12mg/kg IV 12 hourly x 3 doses followed by 6 – 12 mg once daily IV depending upon severity + Gentamicin 1mg/kg IM or IV

8 hourly Duration: 4-6 weeks

or

Daptomycin 6mg/kg IV once a day Duration: 4-6 weeks

If patient is stable, ideally waitblood cultures.

Antibiotic choice as per sensitivity results.

Guidance from Infectious disease specialist or clinical microbiologist is recommended

Infective Endocarditis:

Native valve (awaiting cultures) In Severe Sepsis

S.aureus

(MSSA or MRSA) Risk for gramnegative bacilli

Vancomycin 25- 30 mg/kg loading followed by 15-20 mg/kg IV 12 hourly (maximum 1gm

12

hourly)/teicoplan in 12mg/kg IV 12 hourly x 3 doses followed

by 6 -12 mg once daily IV depending upon severity

AND

Meropenem 1gm IV 8h Duration: 4-6 weeks

Daptomycin 6mg/kg IV once a day

AND

Meropenem 1gm IV q8h

Duration: 4-6 weeks

Modify antibiotics based on culture results and complete 4-6 weeks of antibiotics
Infective Endocarditis: Prosthetic Valve awaiting Cultures Vancomycin 15mg/kg IV 12 hourly (maximum 1gm

12

hourly)/teicoplan in 12mg/kg IV 12 hourly x 3 doses followed by 6 -12 mg once daily IV

depending upon severity +

Gentamicin 1mg/kg q12h IV

Daptomycin can be used in place of Vancomycin/ Teicoplanin for patients unresponsive to or intolerant of Vancomycin/Tei coplanin or with Vancomycin/Gly copeptideresistant isolates Antibiotic choice as per sensitivity. Guidance from Infectious disease specialist or microbiologist is recommended.

You can read the full Guideline by clicking on the following link :

http://www.ncdc.gov.in/writereaddata/linkimages/AMR_guideline7001495889.pdf

Source: self

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