How can we optimize the diagnostic and therapeutic approach to Staphylococcus aureus bacteremia? Expert opinion-based recommendations

Staphylococcus aureus bacteremia (SAB) is associated with a high rate of complications and mortality. The OPENIN Group ("Optimization of Clinical Processes for the Diagnosis and Treatment of Infections"), which is composed of specialists in Infectious Diseases and Clinical Microbiology, aims to generate recommendations to improve the management of conditions with a significant impact on the healthcare system, based on a critical review of the available evidence. At its third meeting (held in October 2025), the Group formulated fifteen questions addressing the diagnostic (including the role of follow-up blood cultures, rapid molecular methods, and nuclear medicine imaging techniques) and therapeutic approach to SAB, either uncomplicated or complicated (such as the indication for combination therapy, the role of early oral step-down and long-acting antibiotics, and the individualization of the duration of treatment, among other aspects). The present review summarizes the literature analyzed on that occasion and provides a set of expert recommendations.