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 66-year-old male with PMH including DM and hypertension (HTN) was admitted for septicemia secondary to cellulitis of the left great toe. He received vancomycin until day 3, when blood cultures revealed MSSA. Oxacillin 2 g every 4 h was administered from hospital days 4 through 7, then oxacillin was changed to ceftriaxone 2 g every 24 h for 4 weeks of therapy.