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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%)
  1. NVIE denotes cases of native valve infective endocarditis. PVIE denotes cases of prosthetic valve infective endocarditis. IV denotes intravenous. IVDUs denotes intravenous drug users. MSSA denotes methicillin-sensitive S. aureus. MRSA denotes methicillin-resistant S. aureus. CoNS denotes coagulase-negative staphylococcus. GNB denotes gram-negative bacilli. Unless specified otherwise, all cohorts were primarily of adult patients. All reports reported follow-up ≥3 months.