A patient with uncomplicated native valve IE is stable and has completed one week of therapy. What is the best option for continuing her treatment?

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In the management of uncomplicated native valve infective endocarditis (IE), patients typically receive a course of IV antibiotics. Once the patient shows stability and a positive response to therapy, transitioning to outpatient parenteral antimicrobial therapy can be a suitable option. This approach allows for continued effective treatment while minimizing hospital stay, addressing both patient convenience and healthcare costs.

Outpatient parenteral antimicrobial therapy enables the patient to maintain necessary antibiotic levels while allowing for greater mobility and quality of life. This transition often requires close monitoring to ensure the patient continues to respond positively to treatment.

In contrast, simply changing to oral therapy might not ensure adequate drug levels or effectiveness, especially when dealing with serious infections like IE. Continuing the current IV therapy for an additional week isn't necessary if the patient is stable and responding well. Switching to ceftriaxone alone might not provide adequate coverage or may not be appropriate based on the patient's specific infective organism and susceptibility profiles.

Therefore, initiating outpatient parenteral antimicrobial therapy represents the optimal choice for a stable patient who has demonstrated improvement after one week of treatment, balancing efficacy with quality of life considerations.

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