ORGANISMS AND ANTIMICROBIAL QUICK GUIDE (GRAM-NEGATIVE ORGANISMS)
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1. Escherichia coli, Klebsiella pneumoniae
1. Escherichia coli, Klebsiella pneumoniae
Preferred
IV: Amoxicillin/clavulanate, Ampicillin/sulbactam, Cefuroxime, Cefoperazone
PO: Amoxicillin/clavulanate, Ampicillin/sulbactam, Cephalexin, Cefuroxime, Trimethoprim-sulfamethoxazole
Alternative
IV: Ceftriaxone, Piperacillin/tazobactam
Comment
Clinical and PK/PD data of Enterobacterales, Pseudomonas aeruginosa and Acinetobacter spp. demonstrate colistin and polymyxin B have limited clinical efficacy, even if an intermediate result is obtained. Colistin and polymyxin B should be used in combination with one or more active antimicrobial agents. Consultation with an infectious disease specialist is recommended.
2. Extended Spectrum Beta-lactamase (ESBL) Enterobacterales
2. Extended Spectrum Beta-lactamase (ESBL) Enterobacterales
Preferred
Ertapenem, Imipenem, Meropenem
Alternative
--
Comment
Clinical and PK/PD data of Enterobacterales, Pseudomonas aeruginosa and Acinetobacter spp. demonstrate colistin and polymyxin B have limited clinical efficacy, even if an intermediate result is obtained. Colistin and polymyxin B should be used in combination with one or more active antimicrobial agents. Consultation with an infectious disease specialist is recommended.
3. Pseudomonas aeruginosa
3. Pseudomonas aeruginosa
Preferred
IV: Ceftazidime, Piperacillin/tazobactam
PO: Ciprofloxacin
Alternative
Cefepime, Meropenem, Imipenem
Comment
Clinical and PK/PD data of Enterobacterales, Pseudomonas aeruginosa and Acinetobacter spp. demonstrate colistin and polymyxin B have limited clinical efficacy, even if an intermediate result is obtained. Colistin and polymyxin B should be used in combination with one or more active antimicrobial agents. Consultation with an infectious disease specialist is recommended.
4. Acinetobacter species
4. Acinetobacter species
Preferred
Cefoperazone/sulbactam
Alternative
--
Comment
Clinical and PK/PD data of Enterobacterales, Pseudomonas aeruginosa and Acinetobacter spp. demonstrate colistin and polymyxin B have limited clinical efficacy, even if an intermediate result is obtained.
Colistin OR polymyxin B should be used in combination with one or more active antimicrobial agents. Consultation with an infectious disease specialist is recommended.
5. Haemophilus influenzae
5. Haemophilus influenzae
Preferred
IV: Ampicillin, Amoxicillin/clavulanate, Ampicillin/sulbactam
Alternative
Ceftriaxone, Cefotaxime
Comment
The results of ampicillin susceptibility tests should be used to predict the activity of amoxicillin.
6. Non-typhoidal Salmonella
6. Non-typhoidal Salmonella
Preferred
IV: Ampicillin, Ceftriaxone
PO: Ciprofloxacin, Trimethoprim/sulfamethoxazole
Alternative
PO: Azithromycin
Comment
--
7. Typhoidal Salmonella (S. enterica ser. Typhi and S. enterica ser. Paratyphi A-C)
7. Typhoidal Salmonella (S. enterica ser. Typhi and S. enterica ser. Paratyphi A-C)
Preferred
IV: Ampicillin, Ceftriaxone
PO: Ciprofloxacin, Trimethoprim-sulfamethoxazole
Alternative
PO: Azithromycin
Comment
--
References:
M100. Performance Standards for Antimicrobial Susceptibility Testing. Clinical and Laboratory Standards Institute. 32nd edition. 2022.
M39. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data. Clinical and Laboratory Standards Institute. 5th edition. 2022.
https://www.sanfordguide.com/ stewardsip/educational-resources/all-about-antibiotic. Resources | Antibiograms - Interpretation & Use (sanfordguide.com)
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