Table 1 Observational studies of oral antibiotic therapy for infective endocarditis
From: Oral antibiotic therapy for the treatment of infective endocarditis: a systematic review
Reference | Cases | Design | Case definition | Microbiology | Assessment of antibiotic susceptibility | Therapy | Cure |
|---|---|---|---|---|---|---|---|
Colli et al, Italy [9] | 12 NVIE and 2 PVIE requiring acute valve replacement(all left-sided) | Retrospective. Mean follow-up was 20.8 ± 7 months | By Duke criteria | MRSA (60%) | Yes | IV vancomycin for 5.3 ± 3.4 days followed by oral linezolid for 3 weeks | 100% |
S. viridans (30%) | |||||||
Enterococcus sp. (10%) | |||||||
Dworkin et al, USA [10] | 13 IVDUs with NVIE (all right-sided with no systemic metastasis) | Prospective. 4-week follow-up | ≥2 positive blood cultures AND any of the following: Vegetations on echocardiogram (definite – 3 cases) OR pulmonary infiltrates/effusion or tricuspid insufficiency murmur (probable – 6 cases) OR no other identifiable source for the infection (possible – 1 case) | S. aureus (100%) | Yes | IV ciprofloxacin and oral rifampin for 1 week followed by oral ciprofloxacin and oral rifampin for 3 weeks | 77% |
Chetty et al, South Africa [11] | 15 NVIE (right-sided vs. left-sided not specified, all cases were considered uncomplicated) | Prospective. 3-year follow-up | Characteristics clinical features AND any of the following: Positive blood cultures OR vegetations on echocardiogram | Streptococcus sp. (60%) | Yes | High dose oral amoxycillin for 6 weeks (47% also received probenecid) | 87% |
Culture negative (40%) | |||||||
Pinchas et al, Israel [12] | 11 NVIE (all left-sided, considered uncomplicated) | Prospective. Follow-up varied from 3 months to 12 years | Fever AND pre-existing valvular heart disease AND multiple positive blood cultures | S. viridans (100%) | Yes | High dose oral ampicillin for 6 weeks with probenecid for the first 4 weeks. IM streptomycin for the first 2 weeks | 90% |
Phillips et al, UK [13] | 13 NVIE (right-sided vs. left-sided not specified) – all children | Retrospective. Follow-up varied from 1-15 years | Pre-existing valvular disease AND characteristic clinical features AND positive blood cultures | S, viridans (62%) Staphylococcus sp. (23%) | Yes | IV therapy for < 2 weeks (92% ≤3 days) followed by oral penicillin V, ampicillin, cloxacillin, flucloxacillin or erythromycin for 6-8 weeks | 100% |
Other streptococci or Enterococcus sp. (15%) | |||||||
Gray et al, UK [14] | 13 NVIE (right-sided vs. left-sided not specified) | Retrospective. 3-month follow-up | Not specified | S. viridans.(62%) | Yes | Oral ampicillin or propicillin (with or without probenecid) for 6 weeks | 92% |
E. faecalis (1%) | |||||||
Culture negative (37%) | |||||||
Campeau et al, Canada [15] | 10 NVIE (right-sided vs. left-sided not specified) | Retrospective. Follow-up varied from 6-30 months | Pre-existing valvular disease AND Characteristic clinical features AND ≥2 positive blood cultures | S. viridans (60%) | Yes | Oral phenithicillin for 4-6 weeks (IM streptomycin for the first 2 weeks in 6 cases, concomitant probenecid in 2 cases) | 80% |
E. faecalis (30%) | |||||||
Anaerobic bacteria (10%) | |||||||
Friedberg et al, USA [16] | 11 NVIE (right-sided vs. left-sided not specified) | Retrospective. Follow-up not specified | Pre-existing rheumatic valvular disease AND Unexplained fever for ≥2½ weeks | S. viridans (55%) | Yes | Oral Aureomycin for 5-8 weeks | 36% |
E. faecalis (18%) | |||||||
Culture negative (27%) | |||||||
Schein et al, USA [17] | 81 NVIE (right-side vs. left-sided not specified) | Retrospective. Follow-up varied from 2-8 years | Not specified | Streptococcus sp. (94%) | Not specified | Oral sulfonamides (sulfanilamide, sulfapyridine, sulfathiazole or sulfadiazine) for 10 days-14 weeks | 10% |
S. aureus (1%) | |||||||
Enterococcus sp. (1%) | |||||||
H. influenza (4%) |