24th June 2026

Antimicrobial therapy

Antibiotic therapy should be targeted based on the microorganism isolated from the blood cultures.  If patients are acutely unwell, empirical antibiotics should be commenced, however, this should be after at least two (preferably three) sets of blood cultures have been taken. The appropriate empirical antibiotic regimen depends on whether the valve in native or prosthetic, and depends on the likely causative microorganism, as summarised in Table 3.

Duration of therapy in NVIE is generally four to six weeks, whilst in PVIE the duration is usually a minimum of six weeks, and additional surgical management is often required.

Table 3: recommended empirical antibiotics in infective endocarditis