From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For Klebsiella urinary tract infections (UTIs), intramuscular (IM) antibiotic therapy is not typically the first-line approach, and fluoxetine is not an appropriate treatment option as it is an antidepressant, not an antibiotic. The preferred treatment is oral antibiotics for uncomplicated cases or intravenous antibiotics for severe or complicated infections. However, if IM administration is necessary, gentamicin 5-7 mg/kg once daily is the most appropriate option, as suggested by studies such as 1. For adults, this typically translates to 240-360 mg once daily for a 70 kg individual. Alternative IM options include ceftriaxone 1-2 g once daily or amikacin 15 mg/kg once daily (approximately 1 g for a 70 kg adult). Some key points to consider in the treatment of Klebsiella UTIs include:
- Obtaining urine cultures before starting antibiotics to confirm the causative organism and its susceptibility pattern, as Klebsiella species increasingly demonstrate antibiotic resistance 2
- Monitoring renal function when using aminoglycosides like gentamicin or amikacin due to their nephrotoxicity risk
- Maintaining adequate hydration throughout treatment
- Considering IM antibiotics as a bridge to oral therapy when possible, with transition to appropriate oral antibiotics based on susceptibility testing as soon as clinically feasible
- Being aware of the latest treatment options for complicated UTIs, including those caused by carbapenem-resistant Enterobacteriaceae, as discussed in studies such as 3.