What is the recommended regimen for patients with infection caused by A defectiva and Granulicatella species and VGS with a penicillin MIC of 0.5 g/mL?
The recommended regimen for patients with infection caused by A defectiva and Granulicatella species and VGS with a penicillin MIC of 0.5 g/mL is a combination regimen that includes ampicillin (12 g/d in divided doses) or penicillin (18-30 million U/D in divided doses or by continuous infusion) plus gentamicin (2-3 divided doses) with infectious diseases consultation to determine the length of therapy. Alternatively, ceftriaxone combined with gentamicin may be a reasonable alternative treatment option for VGS isolates that are susceptible to ceftriaxone on the basis of the Clinical and Laboratory Standards Institute definition and are resistant to penicillin (MIC 0.5 g/mL, as defined in this statement). Currently, there is no reported clinical experience with the combination of ampicillin plus ceftriaxone for IE caused by these organisms. 