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 40-year-old female admitted for a BSI with an abscess on her left arm was hospitalized 2 days prior for new-onset DM. Blood cultures drawn on the day of discharge from the previous hospitalization grew MSSA. New blood cultures were obtained, and she was initiated on vancomycin therapy. On day 2, cultures revealed MSSA; vancomycin was discontinued, and oxacillin 2 g every 4 h was prescribed. On day 5, oxacillin was discontinued and she was discharged with ceftriaxone 2 g every 24 h to complete 4 weeks of therapy.