Antibiotic regimen can cut hospital stay for heart infection in half

For some patients with endocarditis, a heart infection, a treatment that shortens intravenous antibiotic treatment and gives remaining antibiotics orally can reduce hospital stays by half, a study published in the New England Journal of Medicine found.

The findings were presented at the European Society of Cardiology Congress Aug. 28. After the initial phase and surgery, most endocarditis patients are clinically stable and stay in the hospital primarily to complete up to six weeks of intravenous antibiotic treatment, as recommended by guidelines.

The researchers looked at whether it was feasible and safe to shorten the length of intravenous antibiotic treatment and give the rest of the antibiotics orally in some patients with endocarditis.

After at least 10 days of intravenous antibiotics, 400 clinically stable patients with endocarditis were randomly assigned to either ongoing intravenous antibiotics or oral antibiotics. Patients in the oral antibiotics group could receive outpatient treatment.

The researchers tracked the patients for six months after antibiotic treatment for all-cause death, unplanned cardiac surgery, embolic events and reinfection.

Intravenous or oral antibiotics were taken for a median of 18 days. The researchers found a change to oral treatment was as efficient and safe as the conventional continued intravenous treatment for the whole period.

"Shifting to oral antibiotic treatment in stabilized patients with endocarditis was as effective and safe as continued intravenous antibiotic treatment and was given during half the antibiotic treatment period," said principal investigator professor Henning Bundgaard.  "These novel findings may have a significant impact on future clinical practice for the management of patients who are stable."

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