This study involves patients with Infective Endocarditis, which is a serious infection affecting the inner lining of the heart chambers and heart valves. The infection can occur on natural heart valves or artificial ones that have been surgically implanted. The study will use several different antibiotics to treat this condition. These include gentamicin, which is given through an infusion into a vein, and a combination of amoxicillin with clavulanic acid taken by mouth. Other medications that may be used include amoxicillin alone, cefazolin, flucloxacillin, benzylpenicillin, and ceftriaxone, which are given through injections or infusions. Additional oral antibiotics include a combination of sulfamethoxazole with trimethoprim, moxifloxacin, clindamycin, rifampicin, and levofloxacin. The specific bacteria causing the infection will be identified through laboratory tests, and may include various types such as Streptococcus, Enterococcus, Staphylococcus, or other organisms.

The purpose of this study is to evaluate whether switching from antibiotics given through a vein to antibiotics taken by mouth earlier in the treatment process works as well as the standard longer treatment with intravenous antibiotics. The study will follow a standardized treatment plan that allows patients to switch to oral antibiotics after a short period of intravenous treatment. This approach aims to determine if patients can be treated effectively with oral medications, which would potentially allow them to complete treatment outside of the hospital setting while maintaining the same level of effectiveness in fighting the infection.

Patients participating in this study will initially receive intravenous antibiotics while admitted to the hospital for less than ten days. After this initial phase, if their condition is stable and the infection is responding to treatment, they may be switched to oral antibiotics according to the study protocol. Throughout the treatment period, which will last for up to six months, patients will be monitored for any signs that the infection is not responding, any complications, or side effects from the medications. The study will track various outcomes including survival, need for heart surgery, new infection-related complications, and patient satisfaction with the treatment approach. Blood samples will be collected at certain times to measure antibiotic levels and ensure the medications are working properly.