Overview of Enterobacterales pneumonia
Australian Commission on Safety and Quality in Health Care (ACSQHC), 2023Kalil, 2016
The main Enterobacterales that cause pneumonia include Enterobacter, Escherichia and Klebsiella species, but can also include Citrobacter, Morganella, Providencia, Serratia and Yersinia species. If an Enterobacterales species is identified in sputum, this does not always indicate pneumonia and may represent colonisation.
Enterobacterales species can exhibit multidrug resistance – for risk factors for infection with a multidrug-resistant gram-negative bacterium, see Risk factors for infection with a multidrug-resistant gram-negative bacterium. For pneumonia caused by Enterobacterales, treat according to the results of susceptibility testing when available; see:
If the pathogen is known but the results of susceptibility testing are not yet available, consider adding gentamicin or tobramycin to the empirical regimen in critically ill patients; add:
1gentamicin intravenously; see Principles of aminoglycoside use for prescribing considerations and subsequent dosing gentamicin gentamicin gentamicin
adult: see Gentamicin initial dose calculator for adults for initial dose
child younger than 18 years: 7 mg/kg up to 560 mg for initial dose12
OR
1tobramycin intravenously; see Principles of aminoglycoside use for prescribing considerations and subsequent dosing tobramycin tobramycin tobramycin
adult: see Tobramycin initial dose calculator for adults for initial dose
child younger than 18 years: 7 mg/kg up to 560 mg for initial dose12.