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What is A male presenting with respiratory distress is put on a ventilator. Tracheal culture was obtained and sent for diagnosis. In the meanwhile, he was empirically staed on amikacin and ceftriaxone. Culture repo after 48 hrs shows growth of Klebsiella pneumoniae which is ESBL +ve on antimicrobial susceptibility testing. The modification needed in his antibiotic treatment is: and explain in detail?
ESBL +ve Klebsiella pneumoniae is resistant to cephalosporins, aminoglycosides, tetracyclines, and TMP-SMX. It is sensitive to amikacin or carbapenems. Ref: Russo T.A., Johnson J.R. (2012). Chapter 149. Diseases Caused by Gram-Negative Enteric Bacilli. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.