What duration of therapy do you recommend for patients with a vascular graft infection in which the graft has been removed and another graft placed in the infected space?

The duration of antibiotics would also depend on whether the patient had positive blood cultures. At the time that a new graft is placed, graft site cultures should be obtained. This is because the patient may have received antibiotics prior to the procedure for a period of time. It is helpful to have Day 1 of abx when the cultures are negative. From that point, six weeks of antibiotics would be suggested, typically in an intravenous formulation based on cultures.

However in general it is not advisable to place a new graft in an infected space. Instead, a temporary dialysis catheter should be used while the vascular graft infection site is being treated, with 6 weeks of antibiotics. It is also important to evaluate for endocarditis in these cases.