Treatment Guidelines for Oxacillin-Sensitive Staphylococcus hominis Bacteremia

Determining Treatment Duration

• For uncomplicated oxacillin-sensitive Staphylococcus hominis bacteremia, the American College of Cardiology recommends treatment for 10-14 days if all criteria are met, including catheter removal, negative follow-up blood cultures at 72 hours, and no evidence of endocarditis or metastatic infection 1, 2
• The Infectious Diseases Society of America suggests that treatment for complicated bacteremia should last 4-6 weeks if there is persistent bacteremia, endocarditis, or metastatic infection 1, 2, 3

Specific Treatment Regimen

• The European Society of Cardiology recommends using an antistaphylococcal penicillin, such as oxacillin 8-12 g/24 hours IV divided into 3-4 doses, for the treatment of oxacillin-sensitive S. hominis bacteremia 4, 5, 6, 7
• Consider adding gentamicin 3 mg/kg/24 hours IV for the first 3-5 days for native valve infections, although this is more established for S. aureus than coagulase-negative staphylococci 4, 5, 6, 7

Critical Management Steps

• The Infectious Diseases Society of America recommends removing infected catheters immediately for S. hominis bacteremia, as this is the most common source of infection 1, 3
• Obtain repeat blood cultures at 2-4 days (72 hours) after initiating therapy to document clearance, and perform echocardiography to evaluate for endocarditis, particularly if bacteremia persists beyond 72 hours 1, 2, 3