Journal article
Partial Oral Therapy for Infective Endocarditis Among Adult Infectious Diseases Physicians in the United States: An Emerging Infections Network Survey
Open forum infectious diseases, Vol.12(9), ofaf580
09/2025
DOI: 10.1093/ofid/ofaf580
PMCID: PMC12459244
PMID: 41001618
Abstract
Recent clinical trial evidence supports broader use of partial oral therapy (POT) for infective endocarditis (IE), yet real-world uptake in the U.S. has not been investigated.
Adult infectious diseases (ID) physician members of the Infectious Diseases Society of America Emerging Infections Network were surveyed in April-May 2025. A 10-item instrument captured frequency of POT, organism-specific influence, decision factors, barriers, and facilitators.
Among 1531 members, 516 (34%) responded; 452 (88%) of them managed IE. POT was uncommon: 16% never used, 53% used in ≤10% of cases, and only 10% used in >25% of patients. Frequent POT rose with caseload (23% in physicians treating >50 IE cases year vs ≤9% in lower-volume groups,
< .001) and with fewer years in clinical practice (13% in <5 yrs vs 5% in ≥25 yrs,
= .013). Comfort with POT depended on the pathogen: 66% were comfortable switching for
, 52% for Gram-negative bacilli, 19% for methicillin-resistant
. Three quarters of those who used POT finished with a single agent. In people who inject drugs, 34% of physicians often or always considered an oral regimen. Availability of an active oral agent (75%) and the pathogen involved (69%) were the leading decision drivers; principal barriers were fear of relapse (72%), adherence concerns (53%), and insufficient evidence (48%). Respondents most desired clearer guidelines (75%) and additional data (71%).
U.S. adult ID physicians adopt POT for IE sparingly. Updated IE treatment guidelines, additional clinical trial data, and broader access to complex outpatient antimicrobial therapy services may facilitate wider adoption.
Details
- Title: Subtitle
- Partial Oral Therapy for Infective Endocarditis Among Adult Infectious Diseases Physicians in the United States: An Emerging Infections Network Survey
- Creators
- Jack W McHugh - Mayo Clinic in FloridaLarry M Baddour - Mayo Clinic in FloridaSupavit Chesdachai - Mayo Clinic in FloridaSusan E Beekmann - University of IowaPhilip M Polgreen - University of IowaWalter R Wilson - Mayo Clinic in FloridaDaniel C DeSimone - Mayo Clinic in Florida
- Resource Type
- Journal article
- Publication Details
- Open forum infectious diseases, Vol.12(9), ofaf580
- DOI
- 10.1093/ofid/ofaf580
- PMID
- 41001618
- PMCID
- PMC12459244
- NLM abbreviation
- Open Forum Infect Dis
- ISSN
- 2328-8957
- eISSN
- 2328-8957
- Publisher
- OXFORD UNIV PRESS INC
- Grant note
- Centers for Disease Control and Prevention: NU50CK000574 Centers for Disease Control and Prevention
Financial support. This work was supported by the Centers for Disease Control and Prevention (Cooperative Agreement Number 5, grant number NU50CK000574 to P. M. P. and S. E. B.). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
- Language
- English
- Date published
- 09/2025
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984966335202771
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