PO Versus IV Antibiotics for Osteomyelitis and Endocarditis: What’s the Evidence?

Jacqueline Sherbuk, MD
Thursday, August 5, 2021
Category: Bacterial Infections, Cardiac Infections, Hospital Infections, Orthopedic Infections, Pharmacotherapy

Dr. Sherbuk compares and contrasts the advantages and disadvantages of of intravenous versus oral antibiotic therapy regimens in the treatment of infections of bone and the heart in this new podcast. She begins by reviewing the history of osteomyelitis treatment, noting that IV therapy really predominated until the late 1980’s, then the first clinical studies of oral antibiotic therapy for osteo began. Dr. Sherbuk then focuses on the OVIVA trial. She concludes that although multiple RCTs demonstrate noninferiority, further research is needed on this treatment modality. The speaker next reviews PO Step-down therapy for endocarditis, including the POET trial. She concludes that PO step down therapy is an option for certain endocarditis patients, though several issues remain unclear including the length of the IV antibiotic lead-in, the preferred oral regimen, and the frequency of monitoring.

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