From the Guidelines
The recommended oral treatment for Klebsiella pneumonia is Ciprofloxacin 500 mg or 750 mg twice daily for 14 days. This recommendation is based on the British Thoracic Society guideline for bronchiectasis in adults, which suggests Ciprofloxacin as the first-line treatment for coliforms, including Klebsiella 1.
Key Considerations
- The treatment duration is typically 14 days, but this may vary depending on the severity of the infection and the patient's response to treatment.
- It is essential to note that Klebsiella strains may produce extended-spectrum beta-lactamases (ESBLs), making them resistant to many antibiotics, and therefore, treatment should always be guided by culture and sensitivity results.
- Patients should complete the full course of antibiotics even if symptoms improve, stay hydrated, rest adequately, and follow up with their healthcare provider to ensure resolution of the infection.
Alternative Options
- If Ciprofloxacin is not suitable, alternative options may include intravenous Ceftriaxone 2G once daily for 14 days, but this would require hospitalization or close monitoring 1.
- Other oral antibiotics, such as amoxicillin-clavulanate or third-generation oral cephalosporins, may be considered, but their effectiveness against Klebsiella pneumonia is not as well established as Ciprofloxacin.
From the FDA Drug Label
Levofloxacin tablets are indicated in adult patients for the treatment of nosocomial pneumonia due to methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Escherichia coli,Klebsiella pneumoniae, Haemophilus influenzae, or Streptococcus pneumoniae. Levofloxacin tablets are indicated in adult patients for the treatment of community-acquired pneumonia due to methicillin-susceptible Staphylococcus aureus, Streptococcus pneumoniae (including multi-drug-resistant Streptococcus pneumoniae [MDRSP]), Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Chlamydophila pneumoniae, Legionella pneumophila, or Mycoplasma pneumoniae Levofloxacin tablets are indicated in adult patients for the treatment of complicated urinary tract infections due to Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis
The recommended oral treatment for Klebsiella pneumonia is levofloxacin (PO), as indicated for the treatment of:
- Nosocomial pneumonia
- Community-acquired pneumonia
- Complicated urinary tract infections 2
From the Research
Recommended Oral Treatment for Klebsiella Pneumonia
The recommended oral treatment for Klebsiella pneumonia includes:
- Third- and fourth-generation cephalosporins, quinolones, or carbapenems, as stated in the study 3
- Ciprofloxacin, which has been shown to have the best inhibitory effect on Klebsiella pneumoniae non-ESBL and Klebsiella pneumoniae ESBL compared to cotrimoxazole and doxycycline 4
- Oral ciprofloxacin, which has been used successfully to treat community-acquired pneumonia, including cases caused by Klebsiella pneumoniae 5
- Doxycycline, which has been used to treat multidrug-resistant Klebsiella pneumoniae urinary tract infections 6
- Trimethoprim-sulfamethoxazole (co-trimoxazole), which has been shown to be effective in treating carbapenemase-producing Klebsiella pneumoniae infections 7
Key Considerations
- The choice of oral antibiotic should be based on the susceptibility of the Klebsiella pneumoniae isolate and local resistance patterns
- Monotherapy with a single oral antibiotic can be effective, but combination therapy may be necessary in some cases
- The duration of treatment should be individualized based on the severity of the infection and the patient's response to therapy
Available Oral Antibiotics
- Ciprofloxacin
- Cotrimoxazole
- Doxycycline
- Trimethoprim-sulfamethoxazole
- Third- and fourth-generation cephalosporins
- Carbapenems