What is the recommended treatment option for patients with prosthetic valve or valvular prosthetic material endocarditis caused by VGS and S gallolyticus (bovis)?
It is reasonable to administer 6 weeks of therapy with penicillin or ceftriaxone with or without gentamicin for the first 2 weeks. It is reasonable to administer 6 weeks of therapy with a combination of penicillin or ceftriaxone and gentamicin in patients with IE caused by a strain that is relatively or highly resistant to penicillin with a MIC >0.12 g/mL. Vancomycin is useful only for patients who are unable to tolerate penicillin, ceftriaxone, or gentamicin. Ampicillin is an acceptable alternative to penicillin if shortages of penicillin exist.