Version July 2025
| American Heart Association (AHA) | European Society of Cardiology (ESC) | |
| Adult dose | Pediatric dose | Adult dose |
| Daptomycin¶ (10 to 12 mg/kg IV every 24 hours) in combination with ampicillin or ceftaroline for >6 weeks or Daptomycin 10 to 12 mg/kg IV every 24 hours for >6 weeks or LinezolidΔ 600 mg IV or orally every 12 hours for >6 weeks | Consultation with a pediatric infectious disease specialist is recommended | Daptomycin¶ 10 to 12 mg/kg per 24 hours IV once daily for ≥8 weeks plus one of the following Ampicillin 300 mg/kg per 24 hours IV in 4 to 6 divided doses for ≥8 weeks or Ertapenem 2 g IV once daily for ≥8 weeks or Ceftaroline 1800 mg/day IV in 3 divided doses for ≥8 weeks or Fosfomycin 12 g/day IV in 4 divided doses for ≥8 weeks |
HLAR: high-level aminoglycoside resistance; IV: intravenously; MIC: minimum inhibitory concentration.
* Patients with endocarditis caused by these strains, most commonly Enterococcus faecium, should be treated in consultation with an infectious disease specialist; cardiac valve replacement may be necessary for bacteriologic cure; cure with antimicrobial therapy alone may be <50%.
¶ Daptomycin in combination with ampicillin (12 g/day in 4 or 6 divided doses) or ceftaroline (600 mg IV every 8 or 12 hours) is preferred over daptomycin monotherapy. Ertapenem (2 g IV once daily) is another alternative for combination therapy with daptomycin, although clinical experience is more limited than with other combinations. Intravenous fosfomycin is not available in the United States: oral therapy with fosfomycin does not provide efficacious serum concentrations.
Δ Linezolid use may be associated with potentially severe bone marrow suppression, neuropathy, and drug interactions. Monitor hematologic toxicity.