How do you determine the duration of antibiotic therapy in a patient with culture-negative native valve endocarditis who is clinically improving but has no identified organism to guide treatment?

I feel like any time I run into unique endocarditis questions, I'm back in the 2015 guidelines (Baddour et al., PMID 26373316). I do think that this is one of the lingering questions that is not fully answered in the guidelines, however--they are from 2015, and medical science has come a long way. T...

Since endocarditis with negative cultures can occur because of prior antibiotic administration, I would give a 6-week course to ensure adequate coverage. This is a good review article on culture-negative endocarditis from the Journal of the American Heart Association. DeSimone et al., PMID 40094211