Staphylococcus aureus bacteremia (SAB) is still a daily challenge for clinicians. Despite all efforts, the associated mortality and morbidity has not significantly improved in the last 20 years. The available evidence suggests that adherence to some quality-of-care indicators with regard to clinical management is important in improving the outcome of patients, but it is lower than desired in many hospitals; as such, management of patients with SAB by infectious diseases specialists has been demonstrated to contribute in the reduction of the mortality rate of these patients. In this article, the most relevant clinical studies published over the last few years evaluating the efficacy and safety of alternative drugs for the treatment of SAB are reviewed. However, classic drugs are still used in a high proportion of patients because the promising results obtained from in vivo and in vivo studies with these alternative drugs have not translated as frequently as expected into evident superiority in clinical studies. Nevertheless, some data suggest that certain alternatives may offer advantages in specific situations. Overall, an individualised and expert approach is needed in order to decide the best treatment according to the source, severity, complications, patients’ features and microbiological data.

金黄色葡萄球菌菌血症 (SAB) 仍然是临床医生每天面临的挑战。尽管做出了种种努力，但相关的死亡率和发病率在过去 20 年中并未显着改善。现有证据表明，遵守临床管理方面的某些护理质量指标对于改善患者预后很重要，但在许多医院中低于预期；因此，传染病专家对 SAB 患者的管理已被证明有助于降低这些患者的死亡率。在本文中，回顾了过去几年发表的最相关的临床研究，这些研究评估了替代药物治疗 SAB 的有效性和安全性。然而，经典药物仍在高比例的患者中使用，因为使用这些替代药物进行的体内和体内研究中获得的有希望的结果并没有像预期的那样频繁地转化为临床研究中的明显优势。尽管如此，一些数据表明某些替代方案可能在特定情况下具有优势。总的来说，需要个性化和专家的方法，以便根据来源、严重程度、并发症、患者特征和微生物数据决定最佳治疗方法。