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Updated: Aug 6, 2026

Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method
12:03

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Combination of Oral Doxycycline and Rifampin for Pan-Drug Resistant Klebsiella pneumoniae Infection: A Case Report

Ali Akbar Heydari1, Sepideh Elyasi2, Farshad Abedi2

  • 1Research Center for Infection Control & Hand Hygiene, Department of Infectious Diseases, Imam Reza Hospital Mashhad University of Medical Sciences Mashhad Iran.

Clinical Case Reports
|July 26, 2026
PubMed

Insights

Pan-drug resistant Klebsiella pneumoniae infections pose a significant challenge. Oral doxycycline and rifampin offer a potential low-cost salvage therapy when standard treatments fail or are contraindicated.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Pan-drug resistant Klebsiella pneumoniae presents a critical therapeutic hurdle.
  • Standard last-line antibiotics may be unavailable or cause adverse effects.
  • Osteomyelitis and chronic wound infections are severe manifestations.

Purpose of the Study:

  • To report a case of highly resistant Klebsiella pneumoniae infection.
  • To evaluate salvage therapy options when standard treatments are not feasible.
  • To highlight potential alternative treatments for challenging bacterial infections.

Main Methods:

  • A case study of a 45-year-old male patient with multifocal osteomyelitis.
  • Initial treatment failure with colistin and meropenem due to acute kidney injury.
  • Administration of oral doxycycline and rifampin as salvage therapy.

Main Results:

  • The patient experienced rapid resolution of purulent discharge.
  • Significant reduction in inflammatory markers was observed.
  • Doxycycline and rifampin demonstrated efficacy in a salvage setting.

Conclusions:

  • Oral doxycycline plus rifampin may serve as a viable, accessible, and low-cost salvage option.
  • This combination therapy is a potential alternative for pan-drug resistant Klebsiella pneumoniae infections.
  • Effective management strategies are crucial when standard therapies are unavailable or contraindicated.
Keywords:
Klebsiella pneumoniaebacterial drug resistancedoxycyclineosteomyelitisrifampinwound infection

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