A 73 year old man presents to you one week after undergoing successful thyroid surgery. He has a fever(38.7°C), pain on passing urine and frequency. A urine sample was collected and demonstrated 4+ leukocytes and 4+ RBCs. After blood and urine cultures are obtained, you start him on ceftriaxone 1 gram Q24H to be administered in OPAT. Two days later he is afebrile, and reports some improvement in urinary symptoms. The laboratory reports a Serratia marcescens isolate [> 10⁵ CFU/mL] with the susceptibility pattern presented below.
Antimicrobial | Interpretation |
---|---|
Ampicillin | R |
Amoxicillin-clavulanate | R |
Cephalexin | R |
Cephazolin * | R |
Imipenem | I |
Ertapenem | S |
Gentamicin | S |
Tobramycin | S |
Trimethoprim/sulfamethoxazole | R |
Ciprofloxacin | R |
Nitrofurantoin | S |
Fosfomycin | S |
Would you change his antibiotic therapy and, if so, to which antibiotic? Click here for my suggestions Serratia UTI Discussion