What are the recommended treatments for patients with culture-negative PVE?
For patients with culture-negative PVE, coverage for staphylococci, enterococci, and aerobic Gram-negative bacilli is reasonable if the onset of symptoms is within 1 year of prosthetic valve placement. A regimen could include vancomycin, rifampin, gentamicin, and cefepime. If symptom onset is >1 year after valve placement, then IE is more likely to be caused by staphylococci, VGS, and enterococci, and antibiotic therapy for these potential pathogens is reasonable. One initial treatment option could include vancomycin and ceftriaxone.