Suggested parenteral antimicrobial regimens for definitive treatment of bacteremia and other invasive methicillin-susceptible Staphylococcus aureus infections outside the central nervous system in children older than 28 days^[1,2]

IV: intravenously; MSSA: methicillin-susceptible S. aureus; AUC: area under the curve; MRSA: methicillin-resistant S. aureus.

* For prosthetic valve endocarditis, we add gentamicin 3 mg/kg per day IV in 3 doses and rifampin 20 mg/kg per day orally or IV in 2 doses (maximum daily dose 600 mg) for the first 2 weeks of treatment. For other device-related infections (eg, spinal instrumentation, pacemaker, cochlear implant, baclofen pump, prosthetic joint), we add rifampin 20 mg/kg per day orally or IV in 2 doses (maximum daily dose 600 mg) for up to 2 months if rifampin is tolerated and the device remains in place.

¶ Doses up to 150 mg/kg per day in 3 or 4 doses may be used for bone and joint infections (safety data are limited).

Δ Alternative dosing is suggested for clinicians/institutions who follow AUC-guided therapeutic monitoring for vancomycin for serious MRSA infections as suggested by consensus guidelines^[3]; this strategy requires input from a clinical pharmacist, who will provide recommendations for initial dosing. Refer to UpToDate content on invasive staphylococcal infections in children for details of trough-guided and AUC-guided vancomycin dosing.