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Some drugs need to be used with caution in patients with renal dysfunction. The use of nitrofurantoin is contraindicated in patients with an estimated GFR of less than 30 mL/min/1.73m 2 as drug accumulation can lead to increased side effects and impaired recovery of the urinary tract, increasing the risk of treatment failure. [29]
When antibiotic sensitivity testing is completed, it will report the organisms present in the sample, and which antibiotics they are susceptible to. [28] Although antibiotic sensitivity testing is done in a laboratory ( in vitro ), the information provided about this is often clinically relevant to the antibiotics in a person ( in vivo ). [ 36 ]
Nitrofurantoin, sold under the brand name Macrobid among others, is an antibacterial medication of the nitrofuran class used to treat urinary tract infections (UTIs), although it is not as effective for kidney infections. [16] It is taken by mouth. [16] Common side effects include nausea, loss of appetite, diarrhea, and headaches. [16]
Antibiotic sensitivity can also be tested with these cultures, making them useful in the selection of antibiotic treatment. However, women with negative cultures may still improve with antibiotic treatment. [4] As symptoms can be vague and without reliable tests for urinary tract infections, diagnosis can be difficult in the elderly. [11]
Klebsiella aerogenes, [2] previously known as Enterobacter aerogenes, is a Gram-negative, oxidase-negative, catalase-positive, citrate-positive, indole-negative, rod-shaped bacterium. [3] Capable of motility via peritrichous flagella, [ 4 ] it is approximately one to three microns in length.
Carbapenem-resistant Enterobacteriaceae (CRE) have been defined as carbapenem-nonsusceptible and extended-spectrum cephalosporin-resistant Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae complex, Klebsiella pneumoniae, or Klebsiella oxytoca. Some exclude ertapenem resistance from the definition. [5]
Based upon a number of different observations, including that the gram-positive bacteria are the most sensitive to antibiotics and that the gram-negative bacteria are, in general, resistant to antibiotics, it has been proposed that the outer cell membrane in gram-negative bacteria (diderms) evolved as a protective mechanism against antibiotic ...
Klebsiella species are known to also infect a variety of other animals, both as normal flora and opportunistic pathogens. [ 4 ] Klebsiella organisms can lead to a wide range of disease states, notably pneumonia , urinary tract infections , sepsis , meningitis , diarrhea , peritonitis and soft tissue infections.