Vancomycin- resistant enterococci may cause IE, but there are too few reports in the literature to determine the most effective treat- ment. The antibiotic drugs linezolid and daptomycin have activity against vancomycin-resistant enterococci in vitro, and successful treatment of adults with vancomycin-resistant enterococci IE has been reported. The consensus of the writ- ing group is that management of patients with enterococcal IE should always involve infectious disease consultation as the standard of care. Recommendations 1. The treatment regimen for native valve IE caused by susceptible strains of enterococcus should be a combination therapy of penicillin G or ampicillin together with gentamicin for 4 to 6 weeks, with a lon- ger duration of therapy in cases involving prosthetic material (Class I; Level of Evidence A [in adults]). 2. The consensus of the writing group is that manage- ment of patients with enterococcal IE should always involve infectious disease consultation as the stan- dard of care (Class I; Level of Evidence C). Staphylococcal Endocarditis on Native Valves or Prosthetic Material Native Valve IE Staphylococci may be coagulase positive (S aureus) or coagu- lase negative (S epidermidis and various other species) and appear to have overtaken streptococci as the most common cause of IE in children in recent years.24,110,111 This may be attributable in part to the proliferation of intravascular cath- eters, as well as the nonspecificity of the Duke criteria in children causing false-positive diagnoses.Almost all staphylo- cocci are highly resistant to penicillin G and ampicillin.125 For those few that are susceptible to penicillin, penicillin or ampi- cillin will be effective, assuming a highly qualified laboratory has performed antibiotic susceptibility tests. 