Case Study: Oral Antibiotic Tx for Endocarditis
the MPR take:
A case study reported in the journal Annals of Pharmacotherapy highlights the use of oral antibiotic therapy for the treatment of Neisseria elongata endocarditis. While the established treatment for bacterial endocarditis is typically parenteral therapy given for prolonged periods, in this case the patient had refused intravenous (IV) therapy which prompted the administration of oral ciprofloxacin. After 7 weeks of oral ciprofloxacin therapy, the patient's infection completely resolved. Antibiotics such as quinolones are well absorbed and can achieve systemic levels similar to those seen with parenteral dosing. This is the first reported case of successful treatment of Neisseria elongata endocarditis with a completely oral therapy; oral therapy has been used previously to treat Staphylococcus aureus endocarditis in injection drug users. Oral therapy may be more cost-effective and can save the patient time and potential complications typically associated with prolonged IV therapy. However, compliance with oral therapy may not be as good, so IV therapy is still preferred when treating endocarditis. Given the results of this case, for patients where IV therapy is not possible and the pathogen is highly sensitive to an antimicrobial agent that is well-absorbed, oral therapy can produce successful results.