A 36-year-old female was admitted for diabetic ketoacidosis (DKA), sepsis, right hand cellulitis, and a right patellar fracture. Her PMH included ESRD, DM, and diabetic nephropathy. She was treated for DKA in the intensive care unit, and her dialysis port was removed as a source of infection. Dialysis port cultures and blood cultures revealed MSSA. She was initially treated with vancomycin, which was de-escalated to oxacillin for days 5 through 9. Oxacillin was switched to cefazolin 2 g every 48 h for days 10 through 13, then changed to ceftriaxone 2 g every 24 h on day 14. She was discharged home on day 21 with 4 weeks of outpatient ceftriaxone.
A 47-year-old male admitted for MSSA septicemia secondary to a laceration repair on the back of the head 9 days prior had positive surgical site and blood cultures with MSSA. Oxacillin 2 g every 4 h was initiated on day 4. Echocardiogram was negative for vegetations, and on day 11, antimicrobial therapy was switched to ceftriaxone 2 g every 24 h for 6 weeks of therapy.