Klebsiella infections are caused by bacteria of the Klebsiella genus; Klebsiella pneumoniae is the most significant. This species has become resistant to antibiotics and can transmit this resistance to other species of bacteria. Klebsiella is common in hospitals and causes pneumonia and urinary tract infections in catheterized patients. It also tends to affect patients with underlying diseases such as alcoholism, chronic lung disease and diabetes.
- Skill level:
Realize that antibiotic treatment for klebsiella infections depend on the organ system involved. Initial therapy will generally be empirical, and the specific antibiotic will depend on local susceptibility.
Select an antibiotic with high intrinsic activity against Klebsiella pneumoniae such as aminoglycosides, carbapenems, cephalosporins and quinolones. Other antibiotics used to treat klepsiella include ampicillin/sulbactam, ceftazidime, cefepime, ertapenem, gaitfloxacin, levofloxacin, meropenem, moxifloxacin, norfloxacin, piperacillin/tazobactam and ticarcillin/clavulanate.
Use aztreonam or quinolone if the patient is allergic to beta-lactam antibiotics. Quinolone is also effective for patients allergic to carbapenem.
Administer combination therapy for 2 to 3days with aminoglycoside for patients with severe klebsiella infections. Switch to an extended-spectrum cephalosporin when susceptibility is confirmed. Use carbapenems for extended-spectrum beta-lactamase strains.
Use third-generation cephalosporins or quinlones for pneumonia caused by Klebsiella pneumoniae. Empyema, lung abscesses and pulmonary gangrene may need to be treated surgically.
Provide antibiotics orally, except ampicillin, for 3 days to treat susceptible strains of Klebsiella in cases of simple urinary tract infection. More complicated cases may require oral quinolones, intravenous aminoglycosides, aztreonam, imipenem, third-generation cephalosporins or piperacillin/tazobactam.