Background Current management of infective endocarditis include admission and treatment with
parenteral antibiotics for 4 weeks - 6 weeks. Resource demands and psychological issues of
present management strategy make it highly relevant to seek for alternative more lenient
alternatives. Experiences with oral treatment are only sporadically described, but
observational data suggest that oral treatment could be a feasible option. The investigators
have in 2010 treated 12 endocarditis patients with partial oral antibiotics with a 100%
success rate.
Study design The POET study is a Danish multicenter, prospective, randomized, open label
study. The primary aim is to show non-inferiority of partial oral treatment with antibiotics
of endocarditis compared to full parenteral treatment. Stable patients (n=400) with
streptococci, staphylococci or enterococci infecting the mitral valve or the aortic valve
will be included. After a minimum of 10 days of parenteral treatment, patients will be
randomized to oral therapy or parenteral therapy. Special recommendations for oral treatment
have been developed based on expected minimal inhibitory concentrations and pharmacokinetic
calculations. Patients will be followed for 6 months after completion of antibiotic therapy.
The primary endpoint is a composition of all cause mortality, unplanned cardiac surgery,
embolic events and relapse of positive blood cultures with the primary pathogen.