Novel use of oral delafloxacin monotherapy in staphylococcal prosthetic valve endocarditis: A case report

• The aim of our study is to present what, based on an extensive review of the literature, we believe is the first case describing the use of DLFX in the treatment of MRSA-induced tricuspid prosthetic endocarditis, administered orally as monotherapy throughout the entire treatment cycle. • Bacteremia and bacterial endocarditis have traditionally been the subject of exclusively intravenous treatments. However, some authors have summarized an impressive amount of data, demonstrating the high potential of early transition to oral therapy for these infections • Many modern oral antibiotics reach blood levels adequate to exceed the target MIC, as a guarantee of efficacy according to microbiological criteria14. Delafloxacin (DLFX), a new anionic fluoroquinolone, has been approved by the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of bacterial skin and skin structure infections and by the FDA for community-acquired pneumonia. This report describes a novel use of DFX as oral monotherapy in the treatment of staphylococcal prosthetic endocarditis. Prospective data would be useful to identify future opportunities for the use of this new fluoroquinolone in endocarditis both as monotherapy and for oral use,to simplify antibiotic regimen and to improve patients' quality of life and adherence to therapy.