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What Causes Klebsiella Infection While On Treating With Magnex?

Posted on Sat, 16 Aug 2014

Question: hi Dr, my niece was suffering from UTI (E.coli). she was given Magnex inj 0.5 g (IV) twice daily for days (12 july to 16 july). After that urine culture was given on 21 July and got report on 24 July and this time Klebsiella Pneumoniae is reported. can she get K.Pnuemoniae withing 4/5 days after giving Magnex

Answered by Dr. Vaddadi Suresh (24 minutes later)

Brief Answer:
some more information needed please. .

Detailed Answer:
Hi
It is possible to get a second infection while on treatment with antibiotics. The possibilities include drug resistant organisms and complicated UTI.
Was this treatment initiated based on culture sensitivity and MIC levels or just started empirically?
Is ultrasound abdomen taken to rule out any structural abnormalities of the urinary tract?
What's the age and health status of the patient? Any disease like diabetes?
Please answer for better advice.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vaddadi Suresh (15 minutes later)

One day she had frequent urination and Dr adviced for urine culture. she was having E.coli and was given Magnex 0.5g twice (IV) for 5 days(12-16 july). on 21 july again urine culture was done and got report on 25th july and this time K.Pnuemoniae is reported. She was given Magnex after doing urine culture. but she got infected with K.Pnuemoniae 4/5 days after completing the Magnex injection. She is 10 yrs, USG was done, no structural abonarmalities in urinary tract. no diabetes, urea/creatinine, tc/dc are all with normal level. does not this anitibiotic provide protection for next 15 days to 1 month against 2nd infection? is it adviced to go for 2nd antibiotics(her report showing sensitive to amicacin, gentimicin etc) or gor for long term non-antibiotic treatment like with Niftas (something similar)?

Answered by Dr. Vaddadi Suresh (1 hour later)

Brief Answer:
your answers..

Detailed Answer:
Hi,
Urinary infections with two or more organisms is not uncommon.
1. Does not this anitibiotic provide protection for next 15 days to 1 month against 2nd infection?
Ans:Not necessarily. It is extremely important whether the treatment is initiated with THE MOST SENSITIVE ANTIBIOTIC (lowest MIC) or not. A drug with mild sensitivety can well foster drug resistance and is the cause for recurrent infection. If the most sensitive antibiotic is chosen, YES, it will provide protection for the next few weeks or so; if not, it won't. Note that the second cultured organism is a different one and might be resistant to Magnex given earlier.
2. Is it adviced to go for 2nd antibiotics(her report showing sensitive to amicacin, gentimicin etc) or go for long term non-antibiotic treatment like with Niftas (something similar)?
Ans: yes, she is better treated with a second antibiotic (eg:amikacin) with high sensitivety for 1 complete week. NIFTAS IS ALSO AN ANTIBIOTIC and long term prophylaxes at this moment is not recommended, considering her age and lack of structural abnormalities of urinary tract.
Presently, she requires a second antibiotic, a thorough search for the cause of recurrence and observation. She should be fine soon.
Hope i am clear.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar