A 57-year-old male was admitted for sepsis secondary to septic arthritis of the right hip and left shoulder. He had a PMH of rheumatoid arthritis and was receiving long-term immunosuppressive therapy with prednisone. Blood cultures on admission were positive for MSSA. On day 3, the left shoulder was irrigated and debrided. Ceftriaxone 2 g every 24 h was initiated on day 6 for 6 weeks of therapy from first negative blood culture. An MRI revealed erosive changes along both sides of the right hip joint, and an antibiotic spacer was placed on hospital day 7.
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.