From the Guidelines
For Klebsiella aerogenes infections, the recommended first-line antibiotic choice is ceftazidime/avibactam or meropenem/vaborbactam, as they have shown improved clinical outcomes and reduced mortality compared to traditional antibiotic regimens 1. When considering the treatment of Klebsiella aerogenes infections, it is essential to note that the bacterium can produce carbapenemases, such as KPC, which confer resistance to many antibiotics.
- The use of ceftazidime/avibactam or meropenem/vaborbactam is supported by observational studies, which have demonstrated higher clinical success rates and lower mortality compared to other treatment options 1.
- Meropenem/vaborbactam may be considered as the first choice for specific types of infections, such as pneumonia, due to its favorable pharmacokinetic/pharmacodynamic properties and ability to achieve high epithelial lining fluid concentrations 1.
- Imipenem/relebactam and cefiderocol may also be considered as potential alternatives for the treatment of infections involving KPC-producing CRE, although clinical studies on their efficacy in this setting are limited 1. It is crucial to obtain cultures and susceptibility testing to guide definitive therapy and monitor clinical response closely, as K. aerogenes can develop resistance quickly 1.
- Antibiotic stewardship is essential to prevent the emergence of resistant strains and ensure the optimal use of these broad-spectrum antibiotics.
- The site of infection, local epidemiology, and the emergence of resistance to ceftazidime/avibactam should also be considered when selecting the most appropriate treatment option 1.
From the FDA Drug Label
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Imipenem and Cilastatin for Injection, USP (I.V.) and other antibacterial drugs, Imipenem and Cilastatin for Injection, USP (I.V.) should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. Imipenem and Cilastatin for Injection, USP (I.V.) is indicated for the treatment of lower respiratory tract infections caused by susceptible strains of ... Klebsiella species, Imipenem and Cilastatin for Injection, USP (I.V.) is indicated for the treatment of urinary tract infections (complicated and uncomplicated) caused by susceptible strains of ... Klebsiella species, Imipenem and Cilastatin for Injection, USP (I.V.) is indicated for the treatment of intra-abdominal infections caused by susceptible strains of ... Klebsiella species, Imipenem and Cilastatin for Injection, USP (I.V.) is indicated for the treatment of gynecologic infections caused by susceptible strains of ... Klebsiella species, Imipenem and Cilastatin for Injection, USP (I.V.) is indicated for the treatment of bacterial septicemia caused by susceptible strains of ... Klebsiella species, Imipenem and Cilastatin for Injection, USP (I.V.) is indicated for the treatment of skin and skin structure infections caused by susceptible strains of ... Klebsiella species,
Imipenem and Cilastatin for Injection, USP (I.V.) is an appropriate antibiotic choice for Klebsiella aerogenes infection, as it is indicated for the treatment of various infections caused by susceptible strains of Klebsiella species 2.
Gentamicin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the following microorganisms: ... Klebsiella-Enterobacter-Serratia species, Gentamicin injection may be considered as initial therapy in suspected or confirmed gram-negative infections, and therapy may be instituted before obtaining results of susceptibility testing
Gentamicin Injection, USP is also an appropriate antibiotic choice for Klebsiella aerogenes infection, as it is indicated for the treatment of serious infections caused by susceptible strains of Klebsiella-Enterobacter-Serratia species 3.
From the Research
Antibiotic Choice for Klebsiella aerogenes Infection
The choice of antibiotic for treating Klebsiella aerogenes infection depends on various factors, including the severity of the infection, the patient's overall health, and the antibiotic resistance pattern of the bacteria.
- The bacteria Klebsiella pneumoniae, which is closely related to Klebsiella aerogenes, has been found to exhibit resistance to various antibiotics, including cephalosporins, fluoroquinolones, and aminoglycosides 4.
- Studies have shown that the use of carbapenems, such as imipenem, can be effective in treating infections caused by ESBL-producing Klebsiella pneumoniae 5.
- However, the emergence of carbapenem-resistant Klebsiella pneumoniae has made treatment more challenging, and combination therapy with newer antibiotics, such as ceftazidime/avibactam, may be necessary 6, 7.
- Combination therapy, including polymyxin-based combinations, has been shown to be more effective than monotherapy in treating KPC-producing Klebsiella pneumoniae infections 8.
Treatment Options
Some treatment options for Klebsiella aerogenes infection include:
- Carbapenems, such as imipenem, for ESBL-producing strains 5
- Combination therapy with newer antibiotics, such as ceftazidime/avibactam, for carbapenem-resistant strains 6, 7
- Polymyxin-based combinations, such as polymyxin plus carbapenem or polymyxin plus tigecycline, for KPC-producing strains 8
Considerations
When choosing an antibiotic for Klebsiella aerogenes infection, it is essential to consider the following factors: