High-dose cefazolin (10 g daily), given as a continuous infusion (CI), was able to clear community-acquired methicillin-susceptible Staphylococcus aureus (MSSA) pneumonia while not exhibiting any signs of toxicity or adverse effects, highlighting the wide therapeutic index of this first-generation cephalosporin.

The recurrence of pneumonia twice throughout the patient’s hospital course, before receiving the higher dose of cefazolin CI, suggests incomplete clearance of the infection that may have been averted with a longer duration of therapy or higher initial dosing of cefazolin.

Clinicians should consider consultation with the infectious diseases team when patients have complex and severe infections caused by S. aureus.

This report demonstrates nearly 4 weeks total of high-dose cefazolin CI therapy without directly attributable toxicity due to the drug.

Throughout the high-dose cefazolin therapy, the patient’s serum creatinine stayed within the normal range, and there was no indication of hypoprothrombinemia (INR never went above 1.6).

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