Spellberg B, et al. - A time-honored dogma of medicine is the requirement of prolonged intravenous antibiotic courses to treat infective endocarditis (IE), however, high rates of adverse events are encountered in correlation to providing prolonged intravenous antibiotic regimens. Researchers here investigated the efficacy of oral step-down antibiotic therapy vs intravenous-only therapy for IE. Searching PubMed, they identified 21 observational studies examining the effectiveness of oral antibiotics for managing IE, particularly after an initial course of intravenous therapy. Ample data were gained supporting oral step-down vs intravenous-only antibiotic therapy as effective therapeutic option for IE; there were no contrary data. Incorporation of highly orally bioavailable antibiotics as step-down therapy into clinical practice is recommended for IE, after clearing bacteremia and achieving clinical stability with intravenous regimens.