Question 3.3

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?

[Click here to toggle visibility of the answers]

College Answer

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


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.