**8. Vancomycin**

Iv Vancomycin is recommended as an alternative regimen to iv penicillin for those patients who are not able to tolerate penicillin or ampicillin [33].

Bouvet et al. by using an experimental animal model found that Vancomycin alone was as good as combination of Vancomycin and Gentamicin for treatment of endocarditis caused by NVS [58].

Vancomycin susceptibility breakpoint is typically MIC <1 μg/ml and no resistance to Vancomycin among NVS has been reported thus far [62, 64, 66]. It is notable however that MIC90 for Vancomycin is 2 times higher for *G. adiacens* compared to *A. defectiva* or *G. elegans* [62, 66].
