Baddour et al Infective Endocarditis in Adults 1447 Table 8 shows regimens for treatment of NVE caused by rel- atively penicillin-resistant strains (MIC >0.12 <0.5 g/mL). For patients with VGS or S gallolyticus (bovis) IE caused by these relatively resistant strains, it is reasonable to admin- ister penicillin for 4 weeks, together with single daily-dose gentamicin for the first 2 weeks of treatment. Ampicillin is a reasonable alternative to penicillin if shortages of penicillin exist. If the isolate is ceftriaxone susceptible, then ceftriaxone alone may be considered (Class IIb; Level of Evidence C). Vancomycin alone may be a reasonable alternative if the patient is intolerant of -lactam therapy (Class IIb; Level of Evidence C). Consultation with an infectious diseases special- ist is encouraged in both of these scenarios. Recommendations 1. It is reasonable to administer penicillin for 4 weeks with single daily-dose gentamicin for the first 2 weeks of therapy (Class IIa; Level of Evidence B). 2. If the isolate is ceftriaxone susceptible, then ceftri- axone alone may be considered (Class IIb; Level of Evidence C). 3. Vancomycin alone may be a reasonable alternative in patients who are intolerant of -lactam therapy (Class IIa; Level of Evidence C). A defectiva and Granulicatella Species and VGS With a Penicillin MIC 0.5 g/mL The determination of antimicrobial susceptibilities of A defec- tiva and Granulicatella species (both formerly known as nutri- tionally variant streptococci) is often technically difficult, and the results may not be accurate. 