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 40-year-old female admitted for a BSI with an abscess on her left arm was hospitalized 2 days prior for new-onset DM. Blood cultures drawn on the day of discharge from the previous hospitalization grew MSSA. New blood cultures were obtained, and she was initiated on vancomycin therapy. On day 2, cultures revealed MSSA; vancomycin was discontinued, and oxacillin 2 g every 4 h was prescribed. On day 5, oxacillin was discontinued and she was discharged with ceftriaxone 2 g every 24 h to complete 4 weeks of therapy.