Empiric antibiotic regimens should reflect local patterns of infection and antibiotic resistance; however, typical examples of broad-spectrum antibiotic coverage may include Native valves: Vancomycin 15 to 20 mg / kg IV every 8 to 12 hours (not to exceed 2 g per dose) Prosthetic valve: Vancomycin 15 to 20 mg / kg IV every 8 to 12 hours (not to exceed 2 g per dose) plus gentamicin 1 mg / kg IV every 8 hours plus either cefepime 2 g IV every 8 hours or imipenem 1 g IV every 6 to 8 hours (maximum dose 4 g per day) As soon as possible, the empiric drug regimen should be adjusted based on culture results.