As with other IE cases, decisions about outpatient therapy may be individualized on the basis of clinical impression of symptom- atic recovery, cardiovascular stability, assessment of the fam- ily s ability to follow prescribed treatment, and availability of infrastructure for outpatient monitoring. Recommendations 1. We recommend the current standard of care for methicillin-susceptible S aureus endocarditis involv- ing a native valve or other native cardiac tissue, which includes a semisynthetic, -lactamase resistant peni- cillin (nafcillin or oxacillin) given intravenously for a minimum of 4 to 6 weeks, assuming there has been an appropriate microbiological and clinical response to therapy (Class I; Level of Evidence A). 2. The addition of gentamicin for the first 3 to 5 days may be considered and may accelerate the killing of the staphylococci, but this concept is based on extrapolation from experimental models. Addition of gentamicin increases the likelihood of renal and otic toxicity (Class IIb; Level of Evidence C). 3. Treatment of patients with methicillin-resistant staphylococcal endocarditis with vancomycin for a minimum of 6 weeks, with or without gentamicin for the first 3 to 5 days, is recommended except when the organism is not susceptible to vancomycin (Class I; Level of Evidence B). 4. Patients with S aureus endocarditis should be cared for in a medical facility with cardiothoracic surgery capabilities and infectious diseases consultation (Class I; Level of Evidence C). 5. As with other IE cases, decisions concerning out- patient therapy may be considered and may be individualized on the basis of clinical impression of symptomatic recovery, cardiovascular stability, assessment of the family s ability to follow prescribed treatment, and availability of infrastructure for out- patient monitoring (Class IIb; Level of Evidence C). 