Please select the eligibility criteria that correspond to the clinical trial below.
Title: Partial Oral Treatment of Endocarditis
Brief Summary: Background Current management of infective endocarditis include admission and treatment with parenteral antibiotics for 4 weeks - 6 weeks. Resource demands and psychological issues of present management strategy make it highly relevant to seek for alternative more lenient alternatives. Experiences with oral treatment are only sporadically described, but observational data suggest that oral treatment could be a feasible option. The investigators have in 2010 treated 12 endocarditis patients with partial oral antibiotics with a 100% success rate.

Study design The POET study is a Danish multicenter, prospective, randomized, open label study. The primary aim is to show non-inferiority of partial oral treatment with antibiotics of endocarditis compared to full parenteral treatment. Stable patients (n=400) with streptococci, staphylococci or enterococci infecting the mitral valve or the aortic valve will be included. After a minimum of 10 days of parenteral treatment, patients will be randomized to oral therapy or parenteral therapy. Special recommendations for oral treatment have been developed based on expected minimal inhibitory concentrations and pharmacokinetic calculations. Patients will be followed for 6 months after completion of antibiotic therapy. The primary endpoint is a composition of all cause mortality, unplanned cardiac surgery, embolic events and relapse of positive blood cultures with the primary pathogen.


Options:
A: Inclusion Criteria:

* Left-sided endocarditis based on the Duke criteria
* Infected with one of the following microorganisms:

  * Streptococci
  * Enterococcus faecalis
  * Staphylococcus aureus
  * Coagulase-negative staphylococci.
* ≥ 18 years
* At least 10 days of appropriate parenteral antibiotic treatment overall, and at least 1 week of appropriate parenteral treatment after valve surgery
* Afebrile (T \< 38.0) \> 2 days
* Decreasing infection parameters (CRP dropped to less than 25% of peak value or \< 20 mg/l, and white blood cell count \< 15 x 109/l) during antibiotic treatment
* No sign of abscess formation by echocardiography
* Transthoracic and transoesophageal echocardiography performed within 48 hours prior to randomization

Exclusion Criteria:

* Body mass index \> 40
* Concomitant infection requiring intravenous antibiotic therapy
* Inability to give informed consent to participation
* Suspicion of reduced absorption of oral treatment due to abdominal disorder
* Reduced compliance
B: Inclusion Criteria:

* Patients who underwent transcatheter (TAVI) or surgical aortic valve replacement (SAVR) for severe aortic valve stenosis
* Patients aged \>18 years
* Primary aortic valve procedure with a bioprosthesis for AS with or without associated regurgitation.
* TAVI and SAVR with or without associated coronary revascularization
* TAVI and SAVR for AS after any prior major cardiac surgery with exception of any maze procedure and/or closure of the left atrial appendage.

Exclusion Criteria:

* Patients who underwent any prior SAVR or TAVI
* Patients undergoing concomitant procedures on the mitral valve, tricuspid valve or the ascending aorta.
* Patients operated on for aortic valve endocarditis
* Patients operated for isolated aortic valve regurgitation.
C: Inclusion Criteria:

* Documented S. aureus bacteremia within 2 calendar days of the first dose of study medication

Exclusion Criteria:

* Subjects with a creatinine clearance of less than 30 ml/min
* Subjects with pneumonia
* Pregnant, nursing, or lactating
* Documented history of allergy or intolerance to penicillin or vancomycin
* Subjects with osteomyelitis
D: Inclusion Criteria:

* Suspected methicillin-resistant staphyloccocus aureus infective endocarditis on a native valve, prosthetic valve or pacemakers´s electrode or defibrillators with definitive or probable diagnosis by the modified Duke criteria (Li J, et al. Clin Infect Dis. 2000).
* Patients over 18 years.

Exclusion Criteria:

* Patients who did not sign informed consent.
* Patients with active consumption intravenous drug.
* Patients with emergent surgery criteria (\<72 hours).
* Patients or cardiogenic shock.
* Patients with antibiotic active against MRSA over 72 hours or they may need another antibiotic active against MRSA than those in the study.
* Patients with chronic renal failure on hemodialysis who received empirical treatment with vancomycin as a single dose and have a valley ≥ 15 mcg / mL on the third day.
* Patients with MRSA strains resistant to fosfomycin (MIC\> 64 mg / L) (\<10%) or vancomycin (MIC\> 2 mg / L) or with an MIC to vancomycin of 2 mg / L.
* Patients with any formal contraindication to be treated with study drugs
* Patients treated with any investigational drug within 30 days prior to entering the study.

Answer: A