Do you add gentamicin when treating prosthetic valve endocarditis secondary to viridans group Streptococcus with a penicillin-intermediate isolate (MIC >0.125 - <0.5)?   

No, we do not treat patients with such infections with a combination of penicillin and gentamicin. For these infections, we treat with ceftriaxone alone. Monotherapy with ceftriaxone is a more reasonable option than a combination of penicillin and gentamicin because we have every reason to consider...

Thanks for the helpful answer by Dr. Shrestha. I also abandoned gentamicin a few years ago. Too toxic, especially for a contemplated duration of 6 weeks, in my very elderly population, most of whom have diabetes and vascular disease. I think there is very good data even since the 1980s that in STAP...