What are the next steps in managing a sinus infection with Klebsiella oxytoca and skin flora, after restarting Augmentin (amoxicillin/clavulanate) due to previous side effects and residual symptoms?

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Last updated: July 24, 2025View editorial policy

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Management of Sinus Infection with Klebsiella oxytoca

You should complete the full course of Augmentin (amoxicillin-clavulanate) for 10-14 days despite your side effects, as it is the appropriate antibiotic for Klebsiella oxytoca and discontinuing treatment prematurely risks treatment failure and bacterial resistance. 1, 2, 3

Understanding Your Current Situation

Your situation involves several key elements:

  • Day 8 of a sinus infection
  • Culture from day 3 showing Klebsiella oxytoca and skin flora
  • Partial treatment with Augmentin 875mg (only 4 doses total)
  • Side effects causing treatment interruption
  • Improving symptoms with only residual clear nasal mucus and occasional cough with yellow/green phlegm
  • History of recurring sinus infections

Treatment Plan

1. Antibiotic Therapy

  • Continue Augmentin 875mg: This is the first-line treatment for Klebsiella oxytoca infections 2
  • Complete a full 10-14 day course: Even though symptoms are improving, completing the full course is essential to:
    • Prevent recurrence
    • Prevent development of antibiotic resistance
    • Ensure complete eradication of the infection 1, 3

2. Managing Side Effects

  • Take each dose with food to reduce gastrointestinal upset 3
  • If severe gastrointestinal side effects persist despite taking with food, contact your physician about alternative antibiotics:
    • Cefpodoxime (200mg twice daily) or cefuroxime (500mg twice daily) may be better tolerated 2
    • Note that some K. oxytoca strains can be resistant to cefuroxime 4

3. Supportive Measures

  • Adequate hydration
  • Saline nasal irrigation
  • Warm facial packs
  • Steamy showers
  • Sleeping with head elevated 1, 2

Addressing Your Concerns

Is the culture accurate?

Yes, the culture is likely accurate. Klebsiella oxytoca is a known cause of respiratory infections including sinusitis. The presence of skin flora is common in nasal cultures and generally represents contamination rather than pathogenic organisms.

Why did previous cultures show "no growth"?

Previous "no growth" results could be due to:

  • Prior antibiotic use before culture collection
  • Viral rather than bacterial causes of previous infections
  • Technical issues with sample collection or processing

Monitoring and Follow-up

When to expect improvement

  • You should continue to see improvement with consistent antibiotic therapy
  • Most symptoms should significantly improve within 3-5 days of proper antibiotic treatment 2

When to seek further medical attention

Contact your doctor if:

  • Symptoms worsen despite treatment
  • No improvement after 3-5 days of consistent antibiotic therapy
  • Development of new or severe side effects
  • Fever develops or persists 1, 2

Special Considerations

Recurrent Infections

Since you mention recurring sinus infections, consider:

  • Evaluation for underlying risk factors such as allergies or structural abnormalities
  • Possible referral to an ENT specialist or allergist if infections continue to recur 1
  • CT scan of sinuses may be warranted to evaluate for anatomical issues contributing to recurrent infections

Potential Complications

Be aware that Klebsiella oxytoca can occasionally cause antibiotic-associated hemorrhagic colitis, particularly with amoxicillin-containing antibiotics. If you develop severe abdominal pain or bloody diarrhea, seek immediate medical attention 5, 6.

Conclusion

The culture results are valid, and despite your improving symptoms, completing the full course of Augmentin is crucial for proper treatment of Klebsiella oxytoca sinusitis. If side effects become intolerable, promptly discuss alternative antibiotics with your doctor rather than discontinuing treatment.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Antibiotic Treatment Adherence

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Antibiotics-Associated Hemorrhagic Colitis Caused by Klebsiella oxytoca: Two Case Reports.

Pediatric gastroenterology, hepatology & nutrition, 2018

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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