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 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.