Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is detected in a blood culture. Which antibiotic class is the drug of choice for definitive therapy?
- A Third-generation cephalosporins (ceftriaxone)
- B Carbapenems (meropenem) ✓
- C Piperacillin-tazobactam
- D Fluoroquinolones (ciprofloxacin)
Correct answer: B. Carbapenems (meropenem)
Explanation
ESBL enzymes hydrolyse most penicillins and all generations of cephalosporins; carbapenems are resistant to ESBL-mediated hydrolysis and are the standard of care for serious ESBL infections. Piperacillin-tazobactam in vitro susceptibility often does not translate to clinical efficacy (inoculum effect), and fluoroquinolones frequently carry co-resistance in ESBL-producing strains.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.