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Successful clearance of persistent Staphylococcus aureus pneumonia with high-dose continuous infusion cefazolin
Annie A Smelter1, Christopher R Frei1,2, Dan F Smelter1,2
1Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health at San Antonio, San Antonio, Texas, USA.
Background:
Deep-seated Staphylococcus aureus infections are difficult to treat and require appropriate antibiotic regimens for clinical success. Recent studies have shown that continuous infusion (CI) of β-lactam antibiotics is associated with reduced mortality, though optimal dosages remain to be determined. Here, we present a case in which high-dose cefazolin, at 10 g daily CI, was used to safely and successfully clear methicillin-susceptible S. aureus (MSSA) pneumonia.
Case Summary:
A 33-year-old male was admitted to the medical intensive care unit with suspected MSSA community-acquired pneumonia. Over the course of a 43-day hospital stay, the patient's pneumonia relapsed twice following two 5- to 7-day courses of cefazolin 8 g daily CI. Clearance of the pneumonia was achieved after a 14-day course of cefazolin 10 g daily CI, and the patient was discharged.
Conclusion:
Here, we describe a patient with incomplete clearance of MSSA pneumonia despite two 5- to 7-day courses of cefazolin 8 g daily CI. Following a 14-day course of cefazolin 10 g daily CI, the patient's fever and leukocytosis rapidly resolved without direct evidence of drug-related toxicity. This case report provides evidence for the safe and effective use of high-dose cefazolin CI in the clearance of persistent MSSA pneumonia.
Insights
High-dose cefazolin, administered as 10 g daily continuous infusion (CI), successfully treated a patient with persistent methicillin-susceptible Staphylococcus aureus (MSSA) pneumonia. This approach safely cleared the deep-seated infection after standard treatment failed.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- Deep-seated Staphylococcus aureus infections necessitate effective antibiotic strategies.
- Continuous infusion (CI) of beta-lactam antibiotics shows promise in reducing mortality for severe infections.
- Optimal dosing for continuous infusion therapies requires further investigation.
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