Clinical Scorecard: IDSA updates guidance for antimicrobial-resistant gram-negative infections
At a Glance
| Category | Detail |
|---|---|
| Condition | Antimicrobial-resistant gram-negative infections |
| Key Mechanisms | Involves six major pathogen groups: ESBL-E, AmpC-E, CRE, DTR P. aeruginosa, CRAB, and S. maltophilia. |
| Target Population | Adults and children, with specific dosing guidance for adults. |
| Care Setting | U.S. clinical practice |
Key Highlights
- Guidance incorporates newer therapies and evolving evidence.
- Susceptibility testing is central to treatment decisions.
- Empiric treatment should consider infection severity and local resistance patterns.
- Preferred therapies vary based on resistance mechanisms.
- Newer agents expand treatment options for difficult-to-treat infections.
Guideline-Based Recommendations
Diagnosis
- Identify the organism causing the infection and its susceptibility.
Management
- Use carbapenems for invasive ESBL-E infections outside the urinary tract.
- Cefepime is preferred for AmpC-E infections when susceptible.
- Specific treatments recommended for CRE based on resistance mechanism.
Monitoring & Follow-up
- Reassess treatment once organism and susceptibility profile are known.
Risks
- Avoid unnecessary antibiotic use by distinguishing true infection from colonization.
Patient & Prescribing Data
Adults and children with antimicrobial-resistant gram-negative infections.
Transition from intravenous to oral therapy when clinically stable and appropriate.
Clinical Best Practices
- Consider safety, tolerability, cost, and ease of administration when choosing antibiotics.
- Use newer beta-lactam agents for DTR P. aeruginosa based on susceptibility testing.
- Cefiderocol monotherapy is preferred for invasive S. maltophilia infections.
Related Resources & Content
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