Patient Case: Vancomycin for MSSA
A 67 year old 
presents to the 
with an abscess and 
cultures growing MSSA. She was initially started on empiric vancomycin and ceftriaxone. What is the best antibiotic 
adjustment?
A) Stop vanc, continue ceftriaxone
B) Stop ceftriaxone, continue vanc
C) Stop both, start cefazolin
How did others respond?
Reveal the answer
Best Answer
Stop both vancomycin and ceftriaxone and start cefazolin. Did you know cefazolin IMPROVES mortality compared to vanc for treatment of MSSA?
Explanation: Ceftriaxone is active against MSSA but is broader spectrum and higher risk for C. difficile than cefazolin. De-escalation isn’t just about preventing resistance but can also help improve patient outcomes.