From the Guidelines
For treating a Klebsiella urinary tract infection (UTI), trimethoprim-sulfamethoxazole (TMP-SMX, one double-strength tablet twice daily for 14 days) is an appropriate oral antibiotic option if the uropathogen is known to be susceptible 1. When considering treatment options, it's crucial to prioritize the susceptibility of the uropathogen to ensure effective treatment.
- The choice of antibiotic should be guided by culture and sensitivity testing to minimize the risk of antibiotic resistance.
- If the susceptibility is not known, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone or a consolidated 24-h dose of an aminoglycoside, is recommended 1.
- Fluoroquinolones like ciprofloxacin (500 mg twice daily for 7 days) or levofloxacin (750 mg once daily for 5 days) may also be effective, but their use should be considered in the context of local resistance patterns 1.
- Third-generation cephalosporins such as cefpodoxime (100-200 mg twice daily for 7-10 days) or cefdinir (300 mg twice daily for 7-10 days) may also be used as alternative options. It's essential to complete the full course of antibiotics even if symptoms improve quickly and to increase fluid intake to help flush bacteria from the urinary tract. Patients should contact their healthcare provider if symptoms worsen or don't improve within 48-72 hours of starting antibiotics, as this may indicate resistance requiring a change in treatment approach.
From the FDA Drug Label
Levofloxacin tablets are indicated for the treatment of complicated urinary tract infections due to Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis Levofloxacin tablets are indicated for the treatment of complicated urinary tract infections (mild to moderate) due to Enterococcus faecalis, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, or Pseudomonas aeruginosa Levofloxacin tablets are indicated for the treatment of uncomplicated urinary tract infections (mild to moderate) due to Escherichia coli, Klebsiella pneumoniae, or Staphylococcus saprophyticus
The oral antibiotic option for treating a Urinary Tract Infection (UTI) caused by Klebsiella is levofloxacin (PO) 2.
- Indications include complicated and uncomplicated urinary tract infections.
- Key points to consider when prescribing levofloxacin for UTI include the severity of the infection and the susceptibility of the Klebsiella isolate.
From the Research
Oral Antibiotic Options for UTI caused by Klebsiella
- The recommended oral antibiotic options for treating UTIs due to ESBL-producing Klebsiella pneumoniae include:
- These options are considered effective due to their high sensitivity rates against ESBL-producing Enterobacteriaceae, including Klebsiella species 4
- Other oral antibiotics, such as fluoroquinolones (e.g., levofloxacin, ciprofloxacin), may also be considered, but their effectiveness may be limited due to resistance patterns 6, 7