Pathogens
Citrobacter freundii

Citrobacter freundii

Precautions

See 'Additional Information'

General Information

Most Infections

  • Carbapenem: preferred empirically in severe infections until susceptibility known
  • Cefepime is acceptable only when the MIC is ≤2
    • Cefepime MICs ≥4 may have ESBL co-production rendering cefepime less effective
  • Definitive therapy (if susceptible):
    • Fluoroquinolones
    • Cefepime
    • Bactrim

Only acceptable in mild infections/cystitis if susceptible:

  • Zosyn
  • Ceftriaxone

Cystitis

  • Nitrofurantoin (cystitis only)
  • Ceftriaxone
    • Note: oral 3rd gen cephs should not be used unless other options (e.g. nitrofurantoin, Bactrim, fluoroquinolones) are inappropriate
  • Fosfomycin

Slowly fermenting gram negative rod of the Enterobacteriaceae family

GI flora, especially in hospitalized patients.

Infection usually in nosocomial setting.

Nosocomial infections:

  •  UTI
  •  Wound infections
  •  Pneumonia (HAP)
  •  Prosthetic device and line infections

May require contact precautions if MDRO.