To our knowledge, this is the first report of subtherapeutic linezolid concentrations correlated with decreased clinical effectiveness when during treatment of MRSA pneumonia in a patient with morbid obesity.

Although sulfone syndrome appears to be relatively uncommon, healthcare practitioners must be aware of the potentially fatal syndrome associated with dapsone use.

Table 1 ASP recommendations and team actions ASP recommendation, n (%) No change: 28 (41.2) Discontinue antibiotics: 16 (23.5) Decrease duration of antibiotics: 14 (20.6) Infectious Diseases consult: 5 (7.4) Deescalate therapy: 6 (8.8) Escalate therapy: 0 (0.0) Accepted recommendation, n (%) Yes: 45 (66.2) No: 23 (33.8) Action following ASP recommendation, n (%) No change: 40 (58.8) Discontinue antibiotics: 6 (8.8) Decrease duration of antibiotics: 9 (13.2) Infectious Diseases consult: 2 (2.9) Deescalate therapy: 7 (10.3) Escalate therapy: 4 (5.9) Time from test result to antibiotic change, h, mean (range) 13.5 (0.5-40) ASP, antimicrobial stewardship program.