Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome


  • Rahul R. Damor Department of Pharmacology, P. D. U. Government Medical College, Rajkot, Gujarat, India
  • Amita R. Kubavat Department of Pharmacology, P. D. U. Government Medical College, Rajkot, Gujarat, India



Antibiogram, Definitive therapy, Empirical therapy, Klebsiella isolates, Prescription pattern, Resistance, Sensitivity


Background: Antimicrobials are the greatest discovery of the twentieth century. To limit the emergence and spread of resistance, antibiotic therapy should be adjusted according to the results of microbiological culture. Klebsiella isolates causes various types of infections and the incidence of antibiotic resistance is also high in Klebsiella infections. So, Authors plan this study to analyze how the results of microbiological cultures influence the antibiotic use in the treatment of Klebsiella infections.

Methods: It is a record based observational prospective study which assessed the impact of Klebsiella positive culture results on antibiotic prescribing pattern and its impact on clinical outcome. Patients with empirical antibiotic therapy and Klebsiella positive were included and patients with inadequate data were excluded in this study and the data were recorded. Recorded data were entered and analyzed in Microsoft Office Excel-2013. Unpaired student t-test was used to compare the mean duration of hospital stay using Past software (version 3.20).

Results: There were total 400 patients in our study. Amikacin was the most common drug (n=202) used as empirical therapy. Empirical antibiotic therapy was changed in 161(40.25%) patients. Meropenem was the most commonly used definitive drug. Mean duration of hospital stay is less in empirical sensitive antibiotic therapy as compared to empirical resistance antibiotic therapy having p value <0.0001 which shows significant difference between two groups showing better clinical outcome.

Conclusion: Initial empirical therapy with broad-spectrum antimicrobials is a treatment strategy for severe Klebsiella infections.


World Health Organization. World Health Organization Report on Infectious Disease. Overcoming Antimicrobial Resistance. The World Health Report 2000. Geneva: World Health Organization; 2000.

Gumbo T. General Principles of Antimicrobial Therapy. In: Brunton L, editor. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 13th Ed. New York: McGraw Hill; 2011.957-968.

Johnson A. Surveillance of antibiotic resistance. Philosophical Transactions of the Royal Society B: Biol Sci. 2015;370(1670).

Culture Media. In: Ananthnarayan R, Panikar CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press; 2009;34.

John JF Jr, Fishman NO. Programmatic Role of the Infectious Diseases Physician in Controlling Antimicrobial Costs in the Hospital. Clin Infect Dis 1997;24:471-85.

Chiu J, Thompson GW, Austin TW, Hussain Z, John M, Bombassaro AM et al. Antibiotic Prescribing Practices for Catheter Urine Culture Results. Can J Hosp Pharm. 2013;66 (1):13-20.

Berild D, Mohseni A, Diep LM, Jensenius M, Ringertz SH. Adjustment of antibiotic treatment according to the results of blood cultures leads to decreased antibiotic use and costs. J Antimicrob Chemother. 2006;57:326-30.

Rakesh A. Antimicrobial sensitivity pattern of Klebsiella pneumonia isolated from pus from tertiary care hospital and issues related to the rational selection of antimicrobials. J. Chem. Pharm. Res. 2013; 5(11):326-31.

Santana R, Gaspar G. Secular trends in Klebsiella pneumoniae isolated in a tertiary-care hospital: increasing prevalence and accelerated decline in antimicrobial susceptibility. Revista da Sociedade Brasileira de Medicina Tropical. 2016;49(2):177-82.

Berild D, Mohseni A, Diep LM, Jensenius M, Ringertz SH. Adjustment of Antibiotic Treatment According to the Results of Blood Culture Leads to Decreased Antibiotic Use and Cost. J Antimicrobial Chem. 2006;57:326-30.

Kollef M. Broad‐Spectrum Antimicrobials and the Treatment of Serious Bacterial Infections: Getting It Right Up Front. Clin Inf Diseases. 2008;47(S1):3-13.

Micek ST, Roubinian N, Heuring T, Bode M, Williams J, Harrison C, et al. Before-after study of a standardized hospital order set for the management of septic shock. Critical care medicine. 2006 Nov 1;34(11):2707-13.

Podschun R, Ullmann U. Klebsiella spp. as Nosocomial Pathogens: Epidemiology, Taxonomy, Typing Methods, and Pathogenicity Factors. Clinical Microbiol Reviews. 1998;11(4):589-603.

Fahmey S. Early-onset sepsis in a neonatal intensive care unit in Beni Suef, Egypt: bacterial isolates and antibiotic resistance pattern. Korean J Pediatr. 2013;56(8):332.

Paterson DL. Impact of Antibiotic Resistance in Gram-Negative Bacilli on Empirical and Definitive Antibiotic Therapy. Clinical Infectious Diseases. 2008;47:S14-20.

Suryawanshi S. Antibiotic Prescribing Pattern in a Tertiary Level Neonatal Intensive Care Unit. J Clin And Diagnostic Res. 2015;Vol-9(11).

Donovan FM, Windle ML, Herchline TE. Community Acquired Pneumonia Empiric Therapy. Available at: overview. Accessed 23 November 2018.

El Bouamri M, Arsalane L, El Kamouni Y, Zouhair S. Antimicrobial susceptibility of urinary Klebsiella pneumoniae and the emergence of carbapenem-resistant strains: A retrospective study from a university hospital in Morocco, North Africa. African J Urol. 2015;21(1):36-40.

Park S. Third-generation cephalosporin resistance in gram-negative bacteria in the community: a growing public health concern. The Korean J Internal Medicine. 2014;29(1):27.

Azar SL, Ebadi AR. Examining the Pattern of Susceptibility and Antibiotic Resistance in Klebsiella pneumoniae Strains Isolated from Urine Samples of Children with Urinary Tract Infections from the Children's Hospital of Tabriz in 2015. British Biomedical Bulletin. 2017;(5)307.

Mettler J, Simcock M, Sendi P, Widmer AF, Bingisser R, Battegay M et al. Empirical Use of Antibiotics and Adjustment of Empirical Antibiotic Therapies in a University Hospital: a Prospective Observational Study. BMC Infectious Diseases. 2007;7:21.

Eiland EH, Beyda N, Han J, Lindgren W, Ward R, English TM, et al. The Utility of Rapid Microbiological and Molecular Techniques in Optimizing Antimicrobial Therapy. SRX Pharmacol, vol. 2010, Article ID 395215,2010;6.

SARI. A Strategy for the Control of Antimicrobial Resistance in Ireland. Available online at: MicrobiologyAntimicrobialResistance/InfectionControlandHAI/Guidelines/File,41 16,en.pdf. Accessed on: 23 November 2018.

Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, et al. Antibiotic Resistance-The Need for Global Solutions. The Lancet Infectious Diseases. 2013;13(12):1057-98.




How to Cite

Damor, R. R., & Kubavat, A. R. (2019). Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome. International Journal of Basic & Clinical Pharmacology, 8(8), 1819–1824.



Original Research Articles