A man had infection with Extended spectrum betalactamase (ESBL) Klebsiela pneumonae is staed with cefotaxim plus amikacin therapy. On culture sensitivity after 48 hrs ESBL Klebsiela were found. Which of the following would be the best next course of action?
Ans. is 'c' i.e., Sta imipenem therapy in place of ceftriaxone Carbapenems like imipenem are the only beta lactams reliably efficacious against ESBL producing bacteria. Drugs used for ESBL producing bacteria are: A) beta-lactamase inhibitor combination o Clavulinic acid +Amoxcillin Clavulanic acid + Ticarcillin o Sulbactam + ampicillin o Tazobactam + piperacillin B) Cefamycins Cefoxitin, Cefotetan Carbapenems : Imipenem, meropenem
Continue with same antibiotic but in higher dose
Change ceftriaxone to ceftazidime
Sta imipenem therapy in place of ceftriaxone
Change Amikacin to Quinolones