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 55-year-old male was admitted with severe pain secondary to a fall with a PMH for HTN and advanced alcoholic cirrhosis. Blood cultures on day 1 were positive for MSSA. Oxacillin 2 g every 4 h was given on days 3–12. The patient achieved MC but failed to achieve CC (WBCs did not normalize within 7 days). On discharge (day 12), he was switched from oxacillin to ceftriaxone 2 g every 24 h. The patient died from liver disease complications 7 days after discharge.