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 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.