Infectious Diseases

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Oral antibiotics for osteomyelitis and endocarditis

KEY POINT

Switching from I.V. to oral antibiotics, when feasible, is a strategy to decrease antimicrobial resistance. Two noninferiority studies published recently in the New England Journal of Medicine assessed the effects of oral antibiotic therapy for bone and joint infections and partial oral antibiotic treatment for endocarditis.The first study found that oral antibiotics were noninferior to I.V. antibiotics for complex orthopedic infections when given to complete the first 6 weeks of treatment. The second study showed that a switch to oral antibiotics from I.V. therapy was noninferior to I.V. antibiotics for left-sided endocarditis.

SOURCES

Romback HKL, et al. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med. 2019;380(5):425–36. 

Iversen K, et al. Partial oral versus intravenous antibiotic treatment of endocarditis. N Engl J Med. 2019;380(5):415–24. 

Boucher HW. Partial oral therapy for osteomyelitis and endocarditis – is it time? N Engl J Med. 2019;380(5):487–9.