{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T21:59:25Z","timestamp":1781819965613,"version":"3.54.5"},"reference-count":15,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>\n                    Newer methicillin-resistant antimicrobials are needed to address the rising prevalence of methicillin-resistant\n                    <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                    (MRSA) and coagulase-negative (MRCONS) infections. We describe two contrasting, recalcitrant staphylococcal infections successfully managed using early transition to the oral benzoquinolizine antibiotic alalevonadifloxacin, highlighting its utility in complex clinical settings. Two high-severity\u00a0cases of staphylococcal infections are presented. Patient 1, a 58-year-old metastatic lung and orthopedic implant infection\u00a0on hemodialysis, developed catheter-associated MRSA sepsis with bacteremia, endocarditis, and metastatic lung and orthopedic implant infection. Patient 2, a 41-year-old male with a prior craniotomy, presented with a chronic cranial wound infection due to methicillin-resistant\n                    <jats:italic toggle=\"yes\">Staphylococcus hominis<\/jats:italic>\n                    (MRCONS) originating from an infected\n                    <jats:italic toggle=\"yes\">ex vivo<\/jats:italic>\n                    bone flap. Both patients initially received intravenous therapy and were transitioned to oral alalevonadifloxacin upon availability of susceptibility data. Levonadifloxacin susceptibility testing showed an MIC of 2 \u00b5g\/mL for MRSA and 0.047 \u00b5g\/mL for MRCONS-SCV. Patient 1 received 7 weeks of oral therapy aligned with POET recommendation for endocarditis, while Patient 2 completed 8 weeks of oral therapy consistent with OVIVA-based management of osteomyelitis. Despite significant challenges, both patients demonstrated rapid clinical improvement, resolution of infection, and no relapse during follow-up. These cases support oral alalevonadifloxacin as an effective and safe step-down option for complex MRSA and MRCONS infections, including endocarditis, osteomyelitis and meningitis. Alalevonadifloxacin (prodrug of levonadifloxacin) offers a promising oral treatment option when conventional agents are not suitable.\n                  <\/jats:p>","DOI":"10.1177\/10766294261448636","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:22:26Z","timestamp":1778692946000},"page":"321-324","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Transition to Oral Levonadifloxacin in Two Divergent Staphylococcal Infections: Integrating Features of Levonadifloxacin and Evidence from POET and OVIVA Trials"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1578-9932","authenticated-orcid":false,"given":"Rajeev","family":"Soman","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Jupiter Hospital, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanraksha","family":"Mayya","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Jupiter Hospital, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geethu","family":"Joe","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Jupiter Hospital, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1808312"},{"key":"e_1_3_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1710926"},{"key":"e_1_3_7_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02297-17"},{"key":"e_1_3_7_5_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000999"},{"key":"e_1_3_7_6_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001102"},{"key":"e_1_3_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmmb.2024.100528"},{"key":"e_1_3_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab452"},{"key":"e_1_3_7_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S229882"},{"key":"e_1_3_7_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00909-19"},{"key":"e_1_3_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkz493"},{"key":"e_1_3_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf580"},{"key":"e_1_3_7_13_1","unstructured":"12.ICMR annual report 2023 Antimicrobial Resistance Research & Surveillance Network Page 163 Table 7.1."},{"key":"e_1_3_7_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2668199"},{"key":"e_1_3_7_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijabmr.ijabmr_602_21"},{"key":"e_1_3_7_16_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.55178"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294261448636","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10766294261448636","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294261448636","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T21:46:35Z","timestamp":1781819195000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10766294261448636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,1]]}},"alternative-id":["10.1177\/10766294261448636"],"URL":"https:\/\/doi.org\/10.1177\/10766294261448636","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]}}}