[Should infective endocarditis be treated with oral antibiotics?]

The recently published POET trial breaks with the established paradigm of long-term, high-dose intravenous antibiotics for all patients with endocarditis. The study involved 400 Danish patients who had endocarditis caused by Gram-positive micro-organisms and who had a favourable response to initial intravenous therapy. The IV to oral switch appeared to be non-inferior to continuing intravenous treatment. From the perspective of antibiotic stewardship, this is a step forward because a shorter period of intravenous therapy reduces catheter-associated complications. However, treating clinicians should realise that the study had strict inclusion criteria and that its results apply to selected, low-risk patients only.