ASM case reports · 2025
Successful clearance of persistent Staphylococcus aureus pneumonia with high-dose continuous infusion cefazolin.
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Smelter Annie A, Frei Christopher R, Smelter Dan F
Аннотация
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.
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.