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No guidance is available regarding the management of patients with persistent bacteremia due to methicillin-susceptible Staphylococcus aureus (MSSA). Researchers previously described in vitro and in vivo synergism of cefazolin and ertapenem against MSSA. They now describe a case series using this treatment.
Eleven patients with persistent MSSA bacteremia lasting from 4 to 9 days despite antibiotic therapy were given a combination of cefazolin and ertapenem. Initial antibiotic regimens included vancomycin, piperacillin/tazobactam, ceftriaxone, and nafcillin, alone or in various combinations. Six patients had confirmed endocarditis. In the 8 of 9 (89%) instances with relevant measurements, blood cultures were negative within 24 hours after the…