Oral Antimicrobial Treatment vs. Outpatient Parenteral for Infective Endocarditis

Inclusion Criteria:

• Left-sided native or prosthetic infective endocarditis based on the modified Dukecriteria infected with one of the following nonresistant microorganisms:Non-resistant streptococci and other gram positive cocci,e.g., Granulicatella andAbiotrophia; Enterococcus faecalis; Staphylococcus aureus;coagulase-negativestaphylococci and HACEK group.

• Male or female 18 years old or older.

• 10 days or more of appropriate parenteral antibiotic treatment overall and at leastone week of appropriate parenteral treatment after value surgery.

• Temperature inferior to 38ºC for more than two days. 5. C-reactive protein droppedto <25% of peak value or <20 mg/l, and white blood cell count <15x10^9/l duringantibiotic treatment

• Transthoracic / transesophageal echocardiography performed within 48 hours ofrandomization

Exclusion Criteria:

• Body mass index >40

• Concomitant infection requiring intravenous antibiotic therapy

• Inability to give informed consent to participation

• Suspicion of reduced absorption of oral treatment due to abdominal disorder

• Microorganisms with no oral combinations for treatment (two active antibiotics ofdifferent families)

• Any immunosuppressive disease or any medical condition at the discretion of theinvestigator that may preclude oral or OPAT therapy

• No family or appropriate home support

• Reduced compliance

• Women of childbearing potential with a positive pregnancy test, or participants (male or female) who wish to plan a pregnancy during the trial period

• Women in lactancy period