Unknown Infection Site

Community or Hospital Acquired, Past History of MRSA or Intravascular Catheter In Situ

 

Severity(classification)

1st line oral/iv antibiotics

Penicillin allergy
(see explanatory notes)

A/B/C

Grading not applicable

Review doses in renal impairment

BENZYLPENICILLIN 2.4g iv qds or every 4 hours depending on severity
plus
FLUCLOXACILLIN 1g iv qds
plus
GENTAMICIN iv (as per local protocol)

Review use of gentamicin within 72 hours with culture results and consider alternative therapy.  Note that duration of gentamicin treatment should not normally exceed 7 days.

plus

TEICOPLANIN iv every 12 hours for 4 doses then once daily.

Dose

<50kg: 400mg

50-74kg: 600mg

75-100kg: 800mg

>100kg: 1000mg 

Maintain treatment pending pre-dose (trough) level on Day 5. Target level 15-60mg/L. (Click for dosing table)

Review initial therapy within 24 hrs.
If a source of infection becomes apparent use the appropriate antibiotic guideline. Modify therapy based on results of microbiological or other investigations. Discuss with microbiologist if required.

GENTAMICIN iv (as per local protocol)

Review use of gentamicin within 72 hours with culture results and consider alternative therapy.  Note that duration of gentamicin treatment should not normally exceed 7 days.

plus

TEICOPLANIN iv every 12 hours for 4 doses then once daily.

Dose

<50kg: 400mg

50-74kg: 600mg

75-100kg: 800mg

>100kg: 1000mg 

Maintain treatment pending pre-dose (trough) level on Day 5. Target level 15-60mg/L. (Click for dosing table)

Review initial therapy within 24 hrs.
If a source of infection becomes apparent use the appropriate antibiotic guideline. Modify therapy based on results of microbiological or other investigations. Discuss with microbiologist if required.

Last Reviewed: 17/05/17 

For guidance on the administration of intravenous antibiotics click here
(GHNHSFT intranet)