Carbapenems until susceptibility known then may be able to step down to alternate susceptible agent.
Beware of beta-lactams due to inducible resistance. Specific therapy depends upon the location and severity of the infection, fragility of the patient and result of in vitro antimicrobial susceptibility testing.
Providencia spp. have potential to produce "broad-spectrum" beta-lactamases that can hydrolyze penicillins and cephalosporins. Treatment of such organisms can often be challenging.
While resistance may not be detectable initially, it can appear after a period of exposure to beta-lactam antibiotics. Use of penicillins (with or without beta-lactamase inhibitors) and cephalosporins should generally be avoided.
Fosfomycin and nitrofurantoin should be used for cystitis only.
