<prompt> A patient is kept on ceftriaxone and amikacin, ESBL Klebsiella infection is detected . What will you do next?Continue with same antibiotic but in higher doseChange ceftriaxone and add ceftazidimeSta imipenem in place of ceftriaxoneRemove Amikacin  <response>: 1. b-lactamase enzymes are capable of hydrolysing the b-lactam rings the active site of b-lactam antibiotics; thereby deactivating their antibacterial propeies. ESBL is a Class A b-lactamase enzyme. 2. ESBL Extended spectrum beta lactamases are resistant to all Penicillin and 1st2nd3rd cephalosporin and monobactam. 3. But do not affect cephamycins e.g., cefoxitin and cefotetan or carbapenems e.g., meropenem or imipenem. 