<![CDATA[Introduction: Antimicrobial resistance is an emerging global health challenge that may lead to treatment failure and prolonged illness. Although cefazolin resistance is relatively uncommon, it can complicate infectious disease management, including chronic diarrhea. Case: A 7-month-old girl presented with fever and chronic mucoid diarrhea. Despite treatment with multiple antibiotics, including cefazolin, metronidazole, and vancomycin, her symptoms worsened, with diarrhea increasing to seven episodes daily, accompanied by severe anemia and malnutrition. Antibiotic susceptibility testing revealed isolated cefazolin resistance (MIC = 64 μg/mL). After susceptibility-guided treatment with intravenous ciprofloxacin and supportive care, the patient improved significantly and was discharged after 10 days. Discussion: This case highlights the importance of considering antimicrobial resistance in children with persistent diarrhea who fail to respond to empirical antibiotic therapy. Cefazolin resistance likely contributed to treatment failure and clinical deterioration. Early microbiological investigation and susceptibility-guided therapy were essential to achieve clinical recovery and prevent further complications. Conclusion: Clinicians should consider cefazolin-resistant enteric infection in cases of chronic diarrhea with poor response to empirical treatment. Prompt culture and antibiotic susceptibility testing are crucial to guide appropriate antimicrobial therapy and improve patient outcomes.]]>
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