A 56-year-old male presents with pyelonephritis. Ultrasound reveals an obstructed right kidney. Percutaneous nephrostomy is performed.


Blood cultures show 2/2 bottles growing Enterobacter cloacae, sensitive to ceftriaxone.

What antibiotic will you choose and why?

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College Answer

Choose an aminoglycoside or meropenem because it is an ESCAPPM organism and will develop resistance to third gen cephalosporins.

Discussion

This has come up before. Many times.

Previous near-identical questions asking about ESCAPPM organisms include:

ESCAPPM and HACEK bacteria are discussed elsewhere in the Required Reading section.