Important: Therapy
Vancomycin IV as per protocol AND Gentamicin IV as per protocol (Treatment dose)
Notes:
If acute kidney injury, replace Gentamicin with Ciprofloxacin 750mg PO 12 hourly or 400mg IV 8hourly (consider safety issues)
If true vancomycin allergy, replace with Daptomycin 6mg/kg IV daily (monitor CK)