Treatment
As with many bacteria, the recommended treatment has changed as the organism has developed resistances. Klebsiella organisms are often resistant to multiple antibiotics. Current evidence implicates a plasmid as the source of the resistant genes. Klebsiella with the ability to produce extended-spectrum beta-lactamases ESBL are resistant to many classes of antibiotics. The most frequent resistances include resistance to aminoglycosides, fluoroquinolones, tetracyclines, chloram-phenicol, and sulfamethoxazole-trimethoprim.
The choice of a specific antimicrobial agent or agents depends on local susceptibility patterns and on the part of the body that is infected. For patients with severe infections, a prudent approach is the use of an initial short course (48-72 h) of combination therapy, followed by a switch to a specific mono-therapy once the susceptibility pattern is known for the specific patient.
If the specific Klebsiella in a particular patient does not have antibiotic resistance, then the antibiotics used to treat such susceptible isolates include ampicillin/sulbactam, piperacillin/tazobactam, ticarcillin/clavulanate, ceftazidime, cefepime, levofloxacin, norfloxacin, gaitfloxacin, moxifloxacin, meropenem, and ertapenem. Some experts recommend the use of Meropenem for patients with ESBL producing Klebsiella. The claim is that meropenem produces the best bacterial clearing. The use of antibiotics is usually not enough. Surgical clearing (frequently done as interventional radiology drainage) is often needed after the patient is started on antimicrobial agents.
Read more about this topic: Klebsiella Pneumoniae
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