The recently published randomized POET (Partial Oral Treatment of Endocarditis) trial studied 400 patients with stable left-sided IE caused by streptococcus, Enterococcus faecalis, S. aureus, or coagulase-negative staphylococci. Patients who had been on intravenous antibiotics for at CLINICAL STATEMENTS AND GUIDELINES least 10 days were randomized to continuation of the usual course of intravenous antibiotics or discharge to ambulatory treatment with oral antibiotics. As part of the study protocol, patients were reassessed by TEE within 1 to 3 days of completion of their assigned treatment to con- firm that the patient had a sufficient response to therapy. The primary outcome was a composite of all-cause mortality, unplanned cardiac surgery, embolic events, or relapse of bacteremia with the primary pathogen. At 6 months after antibiotic treatment completion, the switch to early oral antibiotic therapy was noninferior to traditional long-term intravenous therapy.51 10. IE in patients with S. aureus bacteremia fre- quently involves normal cardiac valves and is seldom accompanied by the physical stigmata of IE, rendering the diagnosis of the disease dif- ficult. Reliance on physical examination findings and clinical stigmata is likely to result in under- diagnosis of S. aureus IE in a large number of cases. TEE is cost-effective to guide duration of therapy in patients with intravascular catheter associated S. aureus bacteremia, patients with intracardiac electronic devices, or other patients at higher risk of IE (including those with previous prosthetic valve surgery) or associated complica- tions. Despite early diagnosis and appropriate therapy, IE after S. aureus bacteremia is fre- quently associated with disabling and life-threat- ening sequelae. The overall mortality rate of S. aureus IE ranges from 19% to 65%. Other com- plications include HF (20% 50%), paravalvular cardiac abscesses (30% 40%), neurological manifestations (30%), and systemic emboliza- 11. 