A 49-year-old male was admitted for symptoms of an upper respiratory tract infection with a nonhealing diabetic foot wound secondary to longstanding DM with diabetic neuropathy and HTN. Blood cultures revealed MSSA on day 1, and ceftriaxone 2 g every 24 h was initiated on day 2 with clearance observed on day 3. X-rays suggested osteomyelitis, and a below the knee amputation was performed on day 5. Postamputation, ceftriaxone 2 g every 24 h was continued for 4 weeks. The patient was readmitted twice the following month, once for a fall that caused bleeding at the site of the amputation and once for debridement, but cultures did not reveal any MSSA, and no MSSA BSI-related recurrence was noted on either admission.
A 35-year-old female with PMH of invasive breast carcinoma with reported tenderness around her chemotherapy port for 1 week was admitted for Gram-positive BSI. The chemotherapy port was removed on day 2 and cultured MSSA. Vancomycin was discontinued in favor of oxacillin 2 g every 4 h until day 5, when oxacillin was discontinued, and she was discharged on 2 weeks of ceftriaxone 2 g every 24 h.