Do you routinely recommend adjunctive rifampin therapy for the management of Staphylococcus aureus native vertebral osteomyelitis?

The short answer is 'no.' Rifampin was first studied to use with orthopedic hardware infections due to MRSA as a way to penetrate the biofilm layers on the hardware. That concept is true with prosthetic heart valves (but not universally). Can a heart valve develop a Staph aureus biofilm? Yes, but there are no studies to support using it in native valve endocarditis and guidelines reflect this.