What is the recommended empiriocal therapy for a patient with suspected right-sided endocarditis with intravenous drug use history?

The recommended empirical therapy for a patient with suspected right-sided endocarditis, particularly in someone with a history of intravenous drug use, typically involves addressing the most common pathogens associated with this condition. In this context, Staphylococcus aureus is the most frequent organism implicated in right-sided endocarditis, and it can be methicillin-sensitive or methicillin-resistant.

Vancomycin is utilized as it provides effective coverage against methicillin-resistant Staphylococcus aureus (MRSA), which is a significant risk for patients with a history of intravenous drug use. In addition to MRSA coverage, if the bacteria are susceptible, adding an agent such as gentamicin is often beneficial to provide synergy in treating staphylococcal infections, but this is not necessary for the initial choice in suspected cases.

While daptomycin offers a treatment option for complicated skin and soft tissue infections and is effective against MRSA, it doesn't attain adequate concentrations in the lungs, making it less suitable for endocarditis treatment, particularly with right-sided involvement.

In cases where more robust coverage against Gram-negative organisms is necessary or for other specific situations (like if there is concern for other co-infections), additional therapies such as a beta-lactam combined with