Are you routinely using PO antibiotics to treat patients with left-sided endocarditis?

No.

Recent literature has demonstrated successful treatment of patients with endocarditis who have been transitioned to oral treatment. The POET trial was a randomized, controlled trial that enrolled 400 patients who fulfilled modified Duke criteria for definite endocarditis. The trial compared full course intravenous (IV) antibiotics with a transition to oral antibiotics for treatment of left-sided endocarditis. The transition to oral treatment occurred after at least 10 days of IV treatment in pat...

I think that once patients have clinically stabilized, with a known organism, it is a reasonable option to transition to PO antibiotics with a drug that has high oral bioavailability. As noted, the POET trial opened the door for this in clinical practice. We additionally have: McDonald et al., PMID 37523190 (see Table 3- note frequently higher doses to achieve bioavailability, as well as other considerations). There was also, just this month, DeSimone et al., PMID 42708190, which indicates again...

The Partial Oral vs Intravenous Antibiotic treatment for Endocarditis trial compared about 200 patients in groups of oral antibiotics versus intravenous antibiotics for left sided endocarditis. They did find that the oral antibiotic group was noninferior in terms of outcomes. The organisms treated were Streptococcus, E. faecalis, S. aureus, or coagulase-negative staphylococci. There was not much data on MRSA treatment. Other concerns with oral antibiotics would be whether patients with morbid ob...