Within 1 to 3 days before the completion of the assigned antibiotic treatment, TEE was per- formed to confirm that the patient had a suf- ficient response to treatment as part of this 5. In patients with native valve endocarditis, rou- tine use of VKA is not recommended. In patients on VKA for other indications who have IE, VKA discontinuation should be considered at the ini- tial presentation for several reasons: 1) the risk of bleeding associated with any needed urgent invasive procedures, 2) the risk of hemorrhagic stroke, and 3) the possible need for early surgery, which is required in roughly 50% of patients with prosthetic valve endocarditis. There are no RCTs studying the use of bridging therapy with intravenous or subcutaneous anticoagulant ther- apy in patients with IE, but observational studies suggest an increased risk of hemorrhagic stroke in patients on intravenous UFH during the acute phase of acute IE. Decisions about continued anticoagulation and antiplatelet therapy should ultimately be directed by the patient s cardiologist and cardiothoracic surgeon, in consultation with a neurology specialist if neurological findings are clinically present or noted on imaging.11,27 34 6. Two sets of blood culture samples are the mini- mum for a secure microbiological diagnosis of IE. Figure 15. Diagnosis of IE. Colors correspond to Table 2. CT indicates computed tomography; IE, infective endocarditis; 18 F-fluorodeoxyglucose; NVE, native valve endocarditis; PET, positron emission tomography; PVE, prosthetic valve endocarditis; TEE, transesophageal echocardiography; and TTE, transthoracic echocardiography. CLINICAL STATEMENTS AND GUIDELINES Recommendations for Intervention for IE (Continued) COR LOE Recommendations Antibiotic therapy is most effective if the identity and sensitivities of the responsible organism are known. S. aureus is the most common pathogen responsible for prosthetic valve endocarditis but still accounts for only 23% of cases. 