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Suggested regimens for therapy of native valve endocarditis due to enterococcal strains resistant to penicillin, aminoglycosides, and vancomycin*

Suggested regimens for therapy of native valve endocarditis due to enterococcal strains resistant to penicillin, aminoglycosides, and vancomycin*
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 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

or

Ceftaroline 1800 mg/day IV in 3 divided doses

or

Fosfomycin 12 g/day IV in 4 divided doses
The doses in this table are intended for patients with normal kidney function. The doses of many of these agents must be adjusted in the setting of kidney function impairment; refer to the individual drug monographs included within UpToDate for renal dosing adjustments.

ESC: European Society of Cardiology; 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%.

¶ Our approach is in alignment with the ESC; we favor treatment with daptomycin, in combination with an additional agent such as ampicillin, ertapenem, or ceftaroline.

Δ Linezolid use may be associated with potentially severe bone marrow suppression, neuropathy, and drug interactions. Monitor hematologic toxicity.
Data from:
  1. Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: Diagnosis, antimicrobial therapy, and management of complications: A scientific statement for healthcare professionals from the American Heart Association. Circulation 2015; 132:1435.
  2. Baltimore RS, Gewitz M, Baddour LM, et al. Infective endocarditis in childhood: 2015 update: A scientific statement from the American Heart Association. Circulation 2015; 132:1487.
  3. Delgado V, Ajmone Marsan N, de Waha S, et al. 2023 ESC guidelines for the management of endocarditis. Eur Heart J 2023; 44:3948.
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