First Page
LabLens Report.
Header
Reference Id
XXXXXXXXXX
Patient name
XXXXXXXXXXXXXXX
Date of Birth
Feb 10, 1999
Source
Urine
Gender
Female
Provider
XXXXXXXXXXXXXXX
Resulted
Aug 26, 2024
Summary
Summary
The laboratory analysis has identified the presence of Escherichia coli and Klebsiella pneumoniae in the urine specimen, indicating a high and medium risk for urinary tract infection, respectively. Methicillin-resistant PBP2 has been detected, suggesting antibiotic resistance. Based on these findings, Trimethoprim-Sulfamethoxazole recommended for treatment.
Rationale
Rationale
The detection of Escherichia coli and Klebsiella pneumoniae, both common uropathogens, correlates with the clinical presentation of a urinary tract infection. The presence of Methicillin-resistant PBP2 indicates a resistance profile that necessitates the use of Trimethoprim-Sulfamethoxazole which remains effective against resistant strains and is suitable for single-dose therapy.
Guidelines
Guidelines
The patient should be administered Trimethoprim-Sulfamethoxazole at a dosage of 160-800mg orally twice daily for 5 to 7 days . It is important to ensure that the medication is taken on an empty stomach, preferably at bedtime after emptying the bladder to maximize urinary drug concentration and efficacy. No additional doses are required, and the patient should be re-evaluated if symptoms persist.
Pathogens
Pathogens Detected
Klebsiella pneumoniae
2.60M copies/mL
Escherichia coli
4.20M copies/mL
Possible UTI - Urinary tract infection
Resistances
Antibiotic Resistance
Methicillin resistant PBP2
Treatment Choice
Treatment Choice
Trimethoprim-sulfamethoxazole
160-800 mg orally twice a day for 5 to 7 days
A.AlternativeTreatments
Alternative Treatments
Ciprofloxacin-500 mg orally every 12 hours for 5 to 7 days
Nitrofurantoin-100 mg orally every 12 hours for 5 days.
Fosfomycin-3g orally as a single dose
Amoxicillin+Clavulanic acid-250 mg orally every 8 hours or 500 mg orally every 12 hours for 3 to 7 days
Ofloxacin-400 mg orally every 12 hours for 5 to 7 days
Cefuroxime-250 mg orally every 12 hours for 5 to 7 days
Levofloxacin-250 mg orally every 24 hours for 10 days or 750 mg orally every 24 hours for 5 days to 7 days
Cefazolin-1 g IV or IM every 12 hours for at least 3 days
Amoxicillin-250 mg orally every 8 hours or 500 mg every 12 hours
Second Page
Lablens Report.
Reference Id
XXXXXXXXXX
Patient name
XXXXXXXXXXXXXXX
Provider
XXXXXXXXXXXXXXX
Resulted
Aug 26, 2024
Quadrant
Effectiveness
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-
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Issues
Effectiveness
Effectiveness Analysis
Klebsiella pneumoniae | Escherichia coli | |
|---|---|---|
| Trimethoprim-sulfamethoxazole | High | High |
| Ciprofloxacin | High | High |
| Nitrofurantoin | High | High |
| Fosfomycin | Moderate | High |
| Amoxicillin+Clavulanic acid | High | High |
| Ofloxacin | Low | Moderate |
| Cefuroxime | High | Moderate |
| Levofloxacin | Moderate | Moderate |
| Cefazolin | Low | High |
| Amoxicillin | Moderate | Low |
Risks
Issues Analysis
Nitrofurantoin/Hepatic FunctionMay cause hepatic impairment or liver damage, especially in patients with pre-existing liver disease.
Nitrofurantoin/Renal FunctionCan affect renal function, especially in patients with pre-existing renal impairment.
Trimethoprim-sulfamethoxazole/AccessibilityPrioritized as a target of stewardship for having a higher antibiotic resistance potential.
Nitrofurantoin/Side EffectsCommon side effects might include: flatulence, headache, nausea
Amoxicillin+Clavulanic acid/Side EffectsCommon side effects might include: nausea, decreased appetite, stomach ache, urinary retention
Ciprofloxacin/AccessibilityPrioritized as a target of stewardship for having a higher antibiotic resistance potential.
Ofloxacin/AccessibilityPrioritized as a target of stewardship for having a higher antibiotic resistance potential.
Cefuroxime/AccessibilityPrioritized as a target of stewardship for having a higher antibiotic resistance potential.
Levofloxacin/AccessibilityPrioritized as a target of stewardship for having a higher antibiotic resistance potential.
Cefazolin/Hepatic FunctionIntramuscular injected antibiotics pose moderate risk, requiring medical oversight.
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