Beat the Bug: Lactobacillus spp - KASIC

Beat the Bug: Lactobacillus spp

A patient started on empiric ceftriaxone and metronidazole is found to have Lactobacillus rhamnosus bacteremia. Should the antibiotics be changed?

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Best Answer

Yes

Explanation: Lactobacillus spp. can cause clinically significant infections, and usual treatment includes penicillin or broader spectrum options, if needed. Penicillin, piperacillin-tazobactam, carbapenems, and clindamycin generally have low MICs and are considered active. Cephalosporins are generally unreliable and many species are intrinsically resistant to vancomycin. Although Lactobacillus spp are anaerobes, metronidazole should not be used.

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