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Knowledge on practice patterns is warranted. We aimed to describe early-phase monotherapy and combination therapy use in\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      endocarditis treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective, nationwide cohort study was conducted in Denmark between 2016 and 2021. All patients with left-sided\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      endocarditis were derived from the NatIonal Danish endocarditis stUdieS registry (NIDUS). Antimicrobial therapy during the first 10 days was compared between monotherapy and combination therapy. The groups were compared by in-hospital mortality, acute kidney injury and surgery with logistic regression and 6-month relapse and recurrence rate and 6-month mortality rate with Kaplan-Meier estimates and multivariable cox regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 392 patients, 59(15.1%) received monotherapy and 333 (84.9%) combination therapy. Patients in monotherapy were older (median 79.3 versus 76.0 years) and had more comorbidities. Monotherapy comprised ampicillin (74.6%), vancomycin (16.9%) and penicillin (6.8%). Among combination regimens the most frequent were ampicillin +gentamicin (65.4%), ampicillin + linezolid (6.6%) and ampicillin + ceftriaxone (5.1%). Surgical rates were comparable. Acute kidney injury during admission occurred in 20.7% versus 16.6% patients. No significant difference in relapse (5.9% versus 8.5%) or recurrence rates (5.4% versus 6.8%) was found. Similar in-hospital mortality (13.8% vs. 11.9%) and 6-month mortality rates were seen in the monotherapy and combination therapy groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The most common treatment of\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      endocarditis was combination therapy, however certain selected patients were treated with monotherapy with similar outcomes. Use of monotherapy remains controversial and would need testing in a controlled randomized setting.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02974-w","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T08:59:42Z","timestamp":1791017982000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early antimicrobial therapy and clinical outcomes of left-sided Enterococcus faecalis endocarditis: a NIDUS registry study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2120-4611","authenticated-orcid":false,"given":"Anna","family":"Stahl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3298-1467","authenticated-orcid":false,"given":"Lauge","family":"\u00d8stergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3763-6777","authenticated-orcid":false,"given":"Katra","family":"Hadji-Turdeghal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1231-6283","authenticated-orcid":false,"given":"Peter L.","family":"Graversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida Holm Jessen","family":"Knudsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1235-9001","authenticated-orcid":false,"given":"Louise Marqvard","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Dahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2873-5845","authenticated-orcid":false,"given":"Jacob Eifer","family":"M\u00f8ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5026-9193","authenticated-orcid":false,"given":"Niels Eske","family":"Bruun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9655-0493","authenticated-orcid":false,"given":"Jonas Agerlund","family":"Povlsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7664-8570","authenticated-orcid":false,"given":"Claus","family":"Moser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Smerup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Godsk","family":"J\u00f8rgensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3031-1064","authenticated-orcid":false,"given":"S\u00f8ren","family":"Fan\u00f8","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7192-0144","authenticated-orcid":false,"given":"Jannik","family":"Helweg-Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8561-0155","authenticated-orcid":false,"given":"Daniel","family":"Faurholt-Jepsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0563-7049","authenticated-orcid":false,"given":"Henning","family":"Bundgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0504-8487","authenticated-orcid":false,"given":"Kasper","family":"Iversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6635-1466","authenticated-orcid":false,"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2048-4167","authenticated-orcid":false,"given":"Emil L.","family":"Fosb\u00f8l","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"key":"2974_CR1","doi-asserted-by":"publisher","unstructured":"Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H et al. 2023 ESC Guidelines for the management of endocarditis. 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Outside this work Lauge \u00d8stergaard and Niels Eske Bruun report independent research grants from Novo Nordisk Foundation. Henning Bundgaard reports speaker fees from BMS, Sanofi, MSD, Amgen and GE. Lars K\u00f8ber reports Speaker\u2019s honorarium from Bayer, Novartis, Astra-Zeneca, Boehringer, and Novo Nordisk Foundation. Emil L Fosb\u00f8l reports independent research grant from Novo Nordisk Foundation, the Danish Heart Association, The Danish Ministry of research. All other authors report no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study complies with all national ethical guidelines for register-based research established by the Danish National Committee on Health Research Ethics. Data collection was authorized by the Danish Data Protection Agency (P-2020-92).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}