A patient with persistent Staphylococcus aureus pneumonia, refractory to initial antibiotic regimens, achieved successful clearance following treatment with high-dose continuous infusion cefazolin. The infection was identified as *Staphylococcus aureus* through diagnostic methods. This case highlights the challenges in managing deep-seated *S. aureus* infections and demonstrates the efficacy of optimizing beta-lactam pharmacokinetics through continuous infusion, particularly with cefazolin, to overcome treatment failures. The patient's clinical improvement and infection resolution underscore the importance of pharmacokinetic/pharmacodynamic considerations in severe bacterial infections, especially when standard approaches are insufficient.
Key note: High-dose continuous infusion cefazolin can be an effective strategy for persistent *Staphylococcus aureus* pneumonia refractory to conventional treatment.