Intravenous followed by oral antimicrobial therapy for staphylococcal endocarditis

Nine men with ten episodes of staphylococcal endocarditis with valvular vegetation (except one) were treated with intravenous cloxacillin for an average of 10 days and followed by oral cloxacillin or dicloxacillin, both with probenecid, for a total duration of 4 wks. Monitoring of serum bactericidal titers (SBT) showed similar values between the two routes of therapy. All patients were bacteriologically and clinically cured. However, there were 3 recurrences, 2 were drug abusers. One nonabuser had the same staphylococcal species 8 months later. All survived the second episode. This preliminary study supports the contention that intravenous followed by oral therapy for staphylococcal endocarditis may be a viable and a more economical form of therapy.