**10. Management of persistent MRSA bacteremia and vancomycin treatment failures in adult patients**

In cases of persistent positive blood cultures for *S. aureus*, it is necessary to look for deep‐seated infections and hidden foci that continually send particles of infection into the blood stream. Removal of these infectious foci by either drainage or surgical debridement is recommended. When vancomycin is used but the bacteremia persists, high‐dose daptomycin (10 mg/kg/day), if the isolate is susceptible, in combination with another agent such as gentamicin 1 mg/kg IV every 8 h, rifampin 600 mg PO/IV daily, or 300–450 mg PO/IV twice daily, linezolid 600 mg PO/IV BID, TMP‐SMX 5 mg/kg IV twice daily should be considered. But in case of reduced susceptibility to vancomycin and daptomycin, quinupristin‐dalfopristin 7.5 mg/kg/dose IV every 8 h, TMP‐SMX 5 mg/kg/dose IV twice daily, linezolid 600 mg PO/IV twice daily, or telavancin 10 mg/kg/dose IV once daily may be other options.
