The selection of the best alternative for Enterococcus faecalis infective endocarditis (IE) continuation treatment in the outpatient setting is still challenging. Three databases were searched, reporting antibiotic therapies against E. faecalis IE in or suitable for the outpatient setting. Articles the results of which were identified by species and treatment regimen were included. The quality of the studies was assessed accordingly with the study design. Data were extracted and synthesized narratively. In total, 18 studies were included. The treatment regimens reported were classified regarding the main antibiotic used as regimen, based on Aminoglycosides, dual β-lactam, teicoplanin, daptomycin or dalbavancin or oral therapy. The regimens based on aminoglycosides and dual β-lactam combinations are the treatment alternatives which gather more evidence regarding their efficacy. Dual β-lactam is the preferred option for high level aminoglycoside resistance strains, and for to its reduced nephrotoxicity, while its adaptation to the outpatient setting has been poorly documented. Less evidence supports the remaining alternatives, but many of them have been successfully adapted to outpatient care. Teicoplanin and dalbavancin as well as oral therapy seem promising. Our work provides an extensive examination of the potential alternatives to E. faecalis IE useful for outpatient care. However, the insufficient evidence hampers the attempt to give a general recommendation.

中文翻译：

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粪肠球菌心内膜炎和门诊治疗：当前替代方法的系统评价

在门诊病人中，选择粪肠球菌感染性心内膜炎（IE）持续治疗的最佳替代方案仍然充满挑战。搜索了三个数据库，报告了针对粪肠球菌的抗生素治疗IE或适用于门诊环境。包括通过物种和治疗方案鉴定其结果的文章。通过研究设计相应地评估研究的质量。提取数据并进行叙述性合成。总共包括18个研究。报告的治疗方案根据氨基糖苷类，双β-内酰胺，替考拉宁，达托霉素或达巴万星或口服疗法的分类，根据所使用的主要抗生素进行分类。基于氨基糖苷和双重β-内酰胺组合的方案是治疗替代方案，这些方案收集了有关其功效的更多证据。双β-内酰胺是高水平氨基糖苷类耐药菌株及其降低的肾毒性的首选方案，而其对门诊患者的适应性文献报道却很少。较少的证据支持其余的选择，但其中许多已成功地适应了门诊护理。替考拉宁和达巴万星以及口服治疗似乎很有希望。我们的工作广泛研究了以下方面的潜在替代方案粪肠球菌IE可用于门诊。但是，证据不足阻碍了提出一般性建议的企图。