Partial Oral Versus Intravenous Antibiotic Therapy for Endocarditis With Management by a Multidisciplinary Team: A...

Area of Science:

• Cardiology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Oral stepdown therapy for infective endocarditis (IE) is supported by trials but underutilized, particularly in North America.
• Multidisciplinary team management and antibiotic strategies for IE require further evaluation.

Purpose of the Study:

• To evaluate the outcomes of patients with IE treated with either intravenous (IV) or partial oral antibiotic therapy.
• To compare the safety and efficacy of oral stepdown therapy versus exclusive IV therapy in a real-world setting.

Main Methods:

• Single-center retrospective study of 236 patients with definite IE.
• Analysis of clinical and outcomes data using multivariable logistic regression.
• Comparison of outcomes between patients receiving IV therapy alone and those transitioned to partial oral therapy.

Main Results:

• No significant differences in 90-day relapsed infection or all-cause mortality between IV and partial oral therapy groups.
• Oral therapy was not associated with increased 90-day mortality in multivariable analysis.
• Independent predictors of mortality included older age, acute heart failure, and early discharge.

Conclusions:

• Partial oral therapy for IE is safe and effective in selected patients managed by a multidisciplinary team.
• Outcomes of partial oral therapy are comparable to exclusive IV treatment for IE.
• Findings align with European guidelines supporting oral stepdown therapy for IE.