From the FDA Drug Label
Ceftriaxone for Injection is indicated for the treatment of the following infections when caused by susceptible organisms: LOWER RESPIRATORY TRACT INFECTIONS Caused by ... Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, Proteus mirabilis or Serratia marcescens SKIN AND SKIN STRUCTURE INFECTIONS Caused by ... Escherichia coli, Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, URINARY TRACT INFECTIONS (complicated and uncomplicated) Caused by Escherichia coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii or Klebsiella pneumoniae BONE AND JOINT INFECTIONS Caused by ... Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae or Enterobacter species INTRA-ABDOMINAL INFECTIONS Caused by Escherichia coli, Klebsiella pneumoniae
- Infections caused by Enterobacteriaceae family: The drug label indicates that ceftriaxone is effective against various infections caused by susceptible organisms, including several species within the Enterobacteriaceae family, such as Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Proteus mirabilis, and Enterobacter cloacae.
- Key points:
- Ceftriaxone has been shown to be effective against various infections, including lower respiratory tract infections, skin and skin structure infections, urinary tract infections, bone and joint infections, and intra-abdominal infections.
- The drug label provides a list of susceptible organisms, including several species within the Enterobacteriaceae family.
- The use of ceftriaxone should be guided by susceptibility testing and local epidemiology 1, 1.
From the Research
The most effective treatment for infections caused by the Enterobacteriaceae family, particularly for uncomplicated urinary tract infections (UTIs), is fosfomycin, carbapenems, or amikacin, as they have shown high susceptibility rates in recent studies 2, 3. When considering treatment options for various infections caused by the Enterobacteriaceae family, it's essential to prioritize the most recent and highest quality evidence. The Enterobacteriaceae family is a common cause of infections, including urinary tract infections (UTIs), gastrointestinal infections, respiratory infections, intra-abdominal infections, and bloodstream infections.
Treatment Options
- For uncomplicated UTIs, fosfomycin is a recommended option, with a high susceptibility rate of over 95% 3.
- For more complicated infections or those caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, carbapenems or amikacin may be necessary, as they have shown effectiveness in treating these types of infections 2, 4.
- The increasing prevalence of antibiotic resistance, particularly ESBL and carbapenem-resistant Enterobacteriaceae (CRE), necessitates susceptibility testing to guide appropriate therapy, sometimes requiring last-resort antibiotics like colistin or newer agents such as ceftazidime-avibactam 5, 4.
Duration of Therapy
- Recent studies suggest that short-course antibiotic therapy (i.e., ≤7 days) may be sufficient for treating infections caused by Enterobacterales, including those caused by the Enterobacteriaceae family 6.
- The decision on the optimal duration of antibiotic therapy should be multifactorial, taking into account biomarkers, clinical response to therapy, and microbiologic clearance.
Key Considerations
- The emergence of multidrug-resistant organisms and the impact of antibiotic therapy on the intestinal microbiome should be considered when selecting treatment options.
- Hospital costs and the potential for side effects should also be taken into account when determining the most appropriate treatment regimen.