In treating infection, selection of antimicrobial agents is based on c/s reports is rule of thumb. I am sharing a case for the opinion of experts in this forum. A 55 years old woman reported with high-grade fever with uncontrolled rigor and chills. TLC 13,000/ cmm, chest x-ray normal, urine M/E field full of pus cells, diabetics under metformin, glimepiride, vildagliptin. The patient was given ceftriaxone, metrogyl, linzolid iv with iv fluid.
Next day u/s abdomen showed acute pyelonephritis, insulin was initiated in place of oral antidiabetic agents. A sample of urine for c/s, fungus sent, advised CT abdomen whose report was not better than u/s. Nephrologist switches over to meropenem and ofloxacin iv. Urine c/s reports showed resistance to meropenem and whole fluoroquinolone group but he continued these antimicrobial agents. For meropenem, he justified that lab doctors on phone…
