<prompt> A man had infection with Extended spectrum betalactamase ESBL Klebsiela pneumonae is staed with cefotaxim plus amikacin therapy. On culture sensitivity after 48 hrs ESBL Klebsiela were found. Which of the following would be the best next course of action?Continue with same antibiotic but in higher doseChange ceftriaxone to ceftazidimeSta imipenem therapy in place of ceftriaxoneChange Amikacin to Quinolones  <response>: Ans. is c i.e., Sta imipenem therapy in place of ceftriaxone Carbapenems like imipenem are the only beta lactams reliably efficacious against ESBL producing bacteria. Drugs used for ESBL producing bacteria are: A beta-lactamase inhibitor combination o Clavulinic acid Amoxcillin Clavulanic acid Ticarcillin o Sulbactam ampicillin o Tazobactam piperacillin B Cefamycins Cefoxitin, Cefotetan Carbapenems : Imipenem, meropenem 