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Infective Endocarditis — SCE Infectious Diseases MCQ

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HardAntimicrobial StewardshipInfective EndocarditisSCE Infectious Diseases

A clinically stable patient with left-sided streptococcal endocarditis has received effective intravenous treatment, is afebrile, has cleared blood cultures and has no abscess or surgical indication. Which additional condition is required before specialist oral step-down is considered?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Two susceptible high-bioavailability oral agents confirmed by the endocarditis team

The best answer is “Two susceptible high-bioavailability oral agents confirmed by the endocarditis team”. Partial oral therapy is confined to carefully selected stable patients after an adequate initial intravenous phase, exclusion of complications and confirmation that a robust active oral combination can be delivered and monitored. The ESC guideline covers blood-culture-negative endocarditis, antimicrobial strategy, oral step-down selection and surgical indications.

Reference: 2023 ESC Guidelines for infective endocarditis: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Endocarditis-Guidelines