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Despite the long-unquestioned wisdom that endocarditis treatment always requires intravenous antibiotic administration, studies performed since the 1950s have suggested that, in many patients, oral antibiotics perform equally well. Researchers analyzed more-recent oral treatment studies: 21 observational studies published since 1975 and 3 randomized controlled studies performed since 1991.
All patients began treatment with intravenous antibiotics, with duration ranging from several days to several weeks, and then completed “step-down” treatment with one or more oral drugs. The vast majority of cases were caused by gram-positive pathogens, including enterococci and coagulase-negative and methicillin-resistant staphylococci. Although patients …