I have enconuntered referred case (35 years Female with recurrent CVA and RVHD; intubated, semicomatose ) from remote area with carbapenem resistant klebsiella pneumoniae. Culture report showed intermidate sensitivity to Tigecycline and sensitivity to Colistin (MIC was borderline). Culture was done and analysed with BACTEC automated method by microbiologist (Respiratory pathogen). After initial two days of response patient deterioated, second culture showed resistance to colistin also.....left with no antibiotic...patient expired, though the over all morbidity and mortality was high in this patient, this patient left some questions unanswered, 1) What sort of antibiotic policy we are following?
2) What would be the plan if there is nosensitivity for antibiotic in a particular organism? 3) Are we heading towards dead end? 4) Any non pharmacological methods to control infection? (I am…
