A patient is kept on ceftriaxone and amikacin, ESBL Klebsiella infection is detected . What will you do next?
Continue with same antibiotic but in higher dose
Change ceftriaxone and add ceftazidime
Sta imipenem in place of ceftriaxone
Remove Amikacin
1. b-lactamase enzymes are capable of hydrolysing the b-lactam rings (the active site) of b-lactam antibiotics; thereby deactivating their antibacterial propeies. ESBL is a Class A b-lactamase enzyme. 2. ESBL (Extended spectrum beta lactamases) are resistant to all Penicillin and 1st/2nd/3rd cephalosporin and monobactam. 3. But do not affect cephamycins (e.g., cefoxitin and cefotetan) or carbapenems (e.g., meropenem or imipenem).
Bacterial Treatment