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  7. Endocarditis: Antibiotic guideline for Partial Oral Endocarditis Therapy (1269)

Endocarditis: Antibiotic guideline for Partial Oral Endocarditis Therapy (1269)

A guideline is intended to assist healthcare professionals in the choice of disease-specific treatments.

Clinical judgement should be exercised on the applicability of any guideline, influenced by individual patient characteristics. Clinicians should be mindful of the potential for harmful polypharmacy and increased susceptibility to adverse drug reactions in patients with multiple morbidities or frailty.

If, after discussion with the patient or carer, there are good reasons for not following a guideline, it is good practice to record these and communicate them to others involved in the care of the patient.

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Editorial Information

Last reviewed: 18/02/2026

Next review date: 28/02/2029

Author(s): Peter Davies.

Version: 1

Author email(s): peter.davies2@nhs.scot.

Approved By: Antimicrobial Utilisation Committee

Document Id: 1269

References
  • EUCAST v15 Breakpoints. https://www.eucast.org/fileadmin/eucast/pdf/breakpoints/v_15.0_Breakpoint_Tables.pdf. Last accessed 10/12/2025
  • Tissot-Dupont H, Gouriet F, Oliver L, Jamme M, Casalta JP, Jimeno MT, Arregle F, Lavoute C, Hubert S, Philip M, Martel H, Riberi A, Habib G, Raoult D. High-dose trimethoprim-sulfamethoxazole and clindamycin for Staphylococcus aureus endocarditis. Int J Antimicrob Agents. 2019 Aug;54(2):143-148. doi: 10.1016/j.ijantimicag.2019.06.006. Epub 2019 Jun 8. PMID: 31181351.
  • Sarah Freling, Noah Wald-Dickler, Josh Banerjee, etal. Real-World Application of Oral Therapy for Infective Endocarditis: A Multicenter, Retrospective, Cohort Study, Clinical Infectious Diseases, Volume 77, Issue 5, 1 September 2023, Pages 672–679, https://doi.org/10.1093/cid/ciad119
  • Stamboulian D, Bonvehi P, Arevalo C, Bologna R, Cassetti I, Scilingo V, Efron E. Antibiotic management of outpatients with endocarditis due to penicillin-susceptible streptococci. Rev Infect Dis. 1991 Jan-Feb;13 Suppl 2:S160-3. doi: 10.1093/clinids/13.supplement_2.s160. PMID: 2017645.
  • Victoria Delgado, Nina Ajmone Marsan, Suzanne de Waha, Nikolaos Bonaros, Margarita Brida, Haran Burri, et al, ESC Scientific Document Group , 2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM), European Heart Journal, Volume 44, Issue 39, 14 October 2023, Pages 3948–4042, https://doi.org/10.1093/eurheartj/ehad193
  • McDonald EG, Aggrey G, Aslan AT, et al. Guidelines for Diagnosis and Management of Infective Endocarditis in Adults: A WikiGuidelines Group Consensus Statement. JAMA Netw Open. 2023;6(7):e2326366. doi:10.1001/jamanetworkopen.2023.26366
  • Pries-Heje MM, Hjulmand JG, Lenz IT, Hasselbalch RB, Povlsen JA, Ihlemann N, Køber N, Tofterup ML, Østergaard L, Dalsgaard M, Faurholt-Jepsen D, Wienberg M, Christiansen U, Bruun NE, Fosbøl E, Moser C, Iversen KK, Bundgaard H. Clinical implementation of partial oral treatment in infective endocarditis: the Danish POETry study. Eur Heart J. 2023 Dec 21;44(48):5095-5106. doi: 10.1093/eurheartj/ehad715. PMID: 37879115.
  • Iversen K, Ihlemann N, Gill SU, Madsen T, Elming H, Jensen KT, Bruun NE, Høfsten DE, Fursted K, Christensen JJ, Schultz M, Klein CF, Fosbøll EL, Rosenvinge F, Schønheyder HC, Køber L, Torp-Pedersen C, Helweg-Larsen J, Tønder N, Moser C, Bundgaard H. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med. 2019 Jan 31;380(5):415-424. doi: 10.1056/NEJMoa1808312. Epub 2018 Aug 28. PMID: 30152252.