Relai oral de l'antibiothérapie dans les endocardites infectieuses : un pas à franchir?

Abstract

Infective endocarditis (IE) are severe conditions requiring prolonged intravenous antibiotics. Those antibiotics regimens are recommended since long ago but nowadays several antibiotics have a great bioavailability and there is more clinical evidence of the reliability of an oral step-down antibiotic therapy. We found several observational studies and two clinical trials evaluating the efficacy of an oral step-down antibiotic therapy vs prolonged intravenous course for IE. These studies showed no significant difference between oral or intravenous therapy and generally with less adverse event. The oral step-down therapy for infective endocarditis, after few days of intravenous initiation, seems to be an acceptable alternative treatment. New European recommendation coming in 2023 for IE, should officialize the place of oral step-down regimen as more clinical trials are underway to confirm the efficiency of these oral regimens.