Title: Staphylococcus saprophyticus: Which beta-lactam? - ScienceDirect
Headings: Staphylococcus saprophyticus
: Which beta-lactam?

International Journal of Infectious Diseases
Short Communication
Staphylococcus saprophyticus: Which beta-lactam?
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Abstract
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Conflict of interest/funding
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Content: Ceftriaxone is used in the treatment of UTI, mainly where there is a suspicion of pyelonephritis. In this study, 12.5% of patients with MSSS pyelonephritis were treated with ceftriaxone. The MIC distribution for ceftriaxone differed greatly between MSSS and MSSA isolates, with higher MIC values for the former than for the latter ( Figure 1, Figure 2 ). In contrast, the MICs of amoxicillin–clavulanic acid were similarly distributed in the two groups of isolates. These observations are discrepant with EUCAST recommendations, which specify that the susceptibility of staphylococci to ceftriaxone must be interpreted following the cefoxitin susceptibility. According to this rule, all of the MSSS isolates included in this study must be interpreted as susceptible to ceftriaxone. Considering the ceftriaxone MIC values observed for MSSS isolates, this raises questions about a lower susceptibility of MSSS to cephalosporins. Recommendations for the treatment of acute pyelonephritis often include an initial intravenous treatment with ceftriaxone ( Gupta et al., 2011 ). Concurrently, the MIC values of ciprofloxacin were ≤1 μg/ml for all MSSS isolates included in the study, suggesting the possibility of using fluoroquinolones instead of ceftriaxone in pyelonephritis due to MSSS.