Treatment with combination amikacin + meropenem of chronic cystitis caused by multiple antibiotic-resistant Klebsiella pneumoniae in a cat

Abstract

This case report discusses a 5-year-old male Domestic Shorthair cat diagnosed with chronic cystitis, presenting with symptoms such as hematuria, painful urination, and increased frequency of urination. Klebsiella pneumoniae, a bacterium known for its multi-drug resistance, was identified as the causative agent through bacterial cultures. The main purpose of this case report was to identify the bacterial etiology of the cystitis and assess the effectiveness of an alternative antibacterial treatment due to the multi-drug resistant nature of the isolated bacteria. The research question aimed to explore the effectiveness of using alternative antibiotic therapy in treating cystitis caused by multi-drug resistant Klebsiella pneumoniae. Bacteriological cultivation was performed on a midstream urine sample from the affected cat. An in vitro antibiogram test was conducted, revealing resistance to multiple antibiotics. Initial treatment with amikacin was initiated but later adjusted to include meropenem due to a lack of clinical improvement after the first week of therapy. Despite the initial treatment with amikacin, no significant clinical improvement was noted. However, after the introduction of meropenem into the treatment regimen, full clinical recovery was observed after 6 weeks. The combination of amikacin and meropenem demonstrated synergistic effects, effectively treating the cat’s cystitis. The combination of amikacin and meropenem provided a successful alternative treatment for cystitis in a cat caused by multi-drug resistant Klebsiella pneumoniae, highlighting its potential efficacy against similar bacterial infections in veterinary medicine. © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2025.