Monotherapy with pencillin G or a first-generation cephalosporin or vancomycin hydrochloride administered for 4 weeks or 2-week therapy with penicillin together with an aminoglycoside are considered to be standard therapy for patients with penicillin-susceptible streptococcal infective endocarditis.1 While these regimens are safe and effective therapy, experience with their use has been confined largely to the treatment of hospitalized patients. Prior to the report by Francioli et al2 in this issue of JAMA, most authorities have been reluctant to use outpatient therapy in patients with
See also p 264. infective endocarditis because of concern about the development of complications during therapy. The study by Francioli and colleagues is important for several reasons. First, this report confirms and extends a previous study by Stamboulian et al3 demonstrating that 4 weeks of ceftriaxone sodium administered in a single daily dose is effective therapy for patients with penicillin-susceptible streptococcal infective endocarditis.