New Research Finds Shorter Antibiotic Courses Work — But Carry a Higher Risk of Relapse

The findings come from a clinical trial presented at the European Society of Cardiology (ESC) Congress and published by the New England Journal of Medicine. The study focused on adults with infective endocarditis (a bacterial infection of the heart’s inner lining or valves) caused by three types of bacteria: Staphylococcus aureus, Enterococcus faecalis, or streptococcus species. Patients who received tailored-duration antibiotic therapy — meaning the length of their course was adjusted rather than fixed — spent 13 more days alive and free of antibiotics compared with those on standard therapy, according to the journal.

But the trial also recorded a higher incidence of relapse among patients in the tailored group. That trade-off — more antibiotic-free days versus a greater chance of the infection coming back — is likely to shape how clinicians weigh up treatment decisions for this condition

Endocarditis is a serious condition that can damage heart valves and, if untreated, become life-threatening. Standard treatment typically involves several weeks of intravenous antibiotics, which carries its own risks including side effects and the development of antibiotic resistance. The trial’s findings suggest that shortening treatment is achievable in some patients, though the relapse data means a one-size-fits-all approach to reduction isn’t straightforward.

The research was presented at ESC Congress, one of the world’s largest gatherings of heart specialists. No specific figures on overall trial size or patient numbers were included in the published summary.

Anyone with concerns about heart health or a current infection should contact their GP or call NHS 111 for advice. In an emergency, call 999.