Outpatient Management of Infective Endocarditis

Because of unique host defense characteristics of the endocardium, successful therapy for infective endocarditis (IE) has necessitated bactericidal antimicrobial agents, generally administered in high doses for prolonged periods of time. This has required therapy in the hospital setting. However, in recent years, it has become apparent that outpatient therapy is feasible if appropriate agents can be administered at home, for example, using either home parenteral therapy or oral preparations. Over the past few decades, there has been a trend toward reducing inpatient reimbursement for various conditions, including serious infections. The decision to treat IE on an outpatient basis is made more easily if based on previous published experience. Published reports have concluded that outpatient therapy is more appropriate for "uncomplicated" IE caused by relatively susceptible microorganisms. The purpose of this paper is to review data describing the results of management of IE in the outpatient setting.