From the Research
The recommended treatment for Citrobacter koseri infections typically involves antibiotics based on susceptibility testing, with carbapenems like meropenem being a suitable option, especially for resistant strains or critically ill patients, as supported by the most recent study 1. When treating Citrobacter koseri infections, it is essential to consider the severity of the infection and the patient's overall health status.
- For uncomplicated infections, third-generation cephalosporins like ceftriaxone (1-2g IV every 24 hours) or cefotaxime (1-2g IV every 8 hours) may be used as first-line therapy 2.
- For more severe infections, combination therapy with an aminoglycoside such as gentamicin (5-7mg/kg/day) may be beneficial 3.
- Carbapenems like meropenem (1g IV every 8 hours) are appropriate for resistant strains or in critically ill patients, as they have a broad spectrum of in vitro activity against Gram-positive and Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae 4. Treatment duration generally ranges from 7-14 days for uncomplicated infections, while complicated infections such as meningitis or abscesses may require 2-6 weeks of therapy 5.
- Surgical drainage is essential if abscesses are present, and source control (such as removal of infected catheters) is important for successful treatment outcomes 1. It is crucial to note that C. koseri can develop resistance through beta-lactamase production, so susceptibility testing is vital for guiding appropriate antibiotic selection 2. In immunocompromised patients or those with indwelling devices, more aggressive treatment approaches may be necessary, and close monitoring of the patient's condition is essential to ensure the best possible outcome 3.