Treatment is generally for 4 to 6 weeks. See Table 8. Longer therapy may be required for recurrent endocarditis, prosthetic valve endocarditis, endocarditis attributable to uncommon species. *As discussed in the text, these recommendations are based on consensus of experts and not experimental comparative studies (Class IIa; Level of Evidence C). Doses for neonates and infants not included. For cases of infective endocarditis in infants, consult infectious diseases and pediatric clinical pharmacists with special expertise in neonatal and infant clinical pharmacology. Maximum daily dose or adult dose should not be exceeded on a per kilogram basis when treating children. Possibly lifelong suppression if no surgery or relapse after surgery. Table 7. Continued Organism/Condition Recommended Antibiotic Drug/Daily Antibiotic Dose Alternative Antibiotic Drug Choice Baltimore et al Infective Endocarditis in Childhood: 2015 Update 1501 IIb; Level of Evidence C).108 Some members of the writing group questioned whether there is value in taking blood cultures after completion of treatment unless there is evidence of return of symptoms. Streptococcal IE on Native Cardiac Valves (No Prosthetic Material) or Prosthetic Material Native Cardiac Valves This has been the most common form of IE in children for decades; some recent reports show staphylococcal IE over- taking streptococci as the most common organism.24,110,111 Penicillin-susceptible streptococci are those with an MIC of 0.1 g of penicillin per milliliter. In patients with IE caused by penicillin-susceptible streptococci who are able to tolerate a -lactam antibiotic, 2 therapeutic regimens are associated with high cure rates (Table 7) and include penicillin G and ceftriaxone. A 4-week regimen of intravenous aqueous crystalline pen- icillin G (or ampicillin if penicillin G is unavailable) achieves a high cure rate.112 This approach avoids aminoglycoside-con- taining regimens for children with impairment of renal func- tion, concurrently administered nephrotoxic drugs, or eighth cranial nerve impairment. 