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. 2024 Jul 13;13(7):648. doi: 10.3390/antibiotics13070648

Table 1.

IDSA Pathogen and Drug Summary.

ESBL-E CRE CRAB DTR Pseudomonas
Common Pathogens Harboring Beta-lactamase Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis Acinetobacter baumannii Pseudomonas aeruginosa
CDC Threat Level Serious Urgent Urgent Serious
Common Phenotype Resistant to
ceftriaxone		 Resistant to
meropenem or ertapenem		 Resistant to
carbapenems		 Resistant to Psa
covering cephalosporins and/or carbapenems
Common Genotype
(Ambler Class)		 CTX-M-15, GES-1, SHV-2
(A)		 KPC-2, IMI-1, SME-1
(A/D)		 OXA-48, OXA-51, OXA-23/24
(A/C/D)		 AmpC, OXA-10, VIM, GES
(A/B/C/D)
Cystitis Treatment
(mild infection)		 Oral (PO)

  1. Nitrofurantoin

  2. TMP-SMX

  3. FQ (ciprofloxacin, levofloxacin)

  4. Fosfomycin (E. coli only)


Intravenous (IV)

  1. Carbapenem (ertapenem, meropenem, imipenem-cilastatin)

  2. Single dose of aminoglycoside (tobramycin or gentamicin)

 Oral (PO)

  1. Nitrofurantoin

  2. TMP-SMX

  3. FQ (ciprofloxacin, levofloxacin)


Intravenous (IV)

  1. Single dose of aminoglycoside (tobramycin or gentamicin) (CR/MDR infection)

  2. Ceftazidime-avibactam (CR infection)

  3. Meropenem-vaborbactam (CR infection)

  4. Imipenem-cilastatin-relebactam (CR infection)

  5. Cefiderocol (CR/MBL/MDR infection)

  6. Colistin/polymyxin B (MDR infection)

 Intravenous (IV)

  1. High dose ampicillin-sulbactam (up to 27 g/day)

  2. Sulbactam-durlobactam

  3. Cefiderocol (MDR/MBL)

 Oral (PO)

  1. FQ (ciprofloxacin, levofloxacin)


Intravenous (IV)

  1. Cefepime (not CR)

  2. Piperacillin-tazobactam (not CR)

  3. Ceftazidime (not CR)

  4. Carbapenem (meropenem, imipenem-cilastatin)

  5. Aztreonam (not CR/combination for MBL with avibactam)

  6. Aminoglycoside (tobramycin, amikacin)

  7. Ceftolozane-tazobactam (CR infection)

  8. Ceftazidime-avibactam (CR infection)

  9. Imipenem-cilastatin-relebactam (CR infection)

  10. Cefiderocol (CR/MBL/MDR infection)

  11. Colistin/polymyxin B (MDR infection)
Non-Cystitis Treatment
(moderate-severe infection)		 Oral (PO)

  1. TMP-SMX

  2. FQ (ciprofloxacin, levofloxacin)


Intravenous (IV)

  1. Carbapenem (meropenem, imipenem-cilastatin, ertapenem)

  2. Aminoglycoside (tobramycin, gentamicin, amikacin) (CR/MDR infection)

  3. Ceftolozane-tazobactam (CR infection)

  4. Ceftazidime-avibactam (CR infection)

  5. Imipenem-cilastatin-relebactam (CR infection)

  6. Cefiderocol (CR/MBL/MDR infection)

  7. Eravacycline (cIAI)

  8. Colistin/polymyxin B (MDR infection)

 Oral (PO)

  1. TMP-SMX

  2. FQ (ciprofloxacin, levofloxacin)


Intravenous (IV)

  1. Ceftazidime-avibactam (CR infection)

  2. Meropenem-vaborbactam (CR infection)

  3. Imipenem-cilastatin (CR infection)

  4. Cefiderocol (CR/MBL/MDR) infection)

  5. Aminoglycosides (tobramycin, gentamicin, or amikacin) (CR/MDR infection)

 Intravenous (IV)

  1. High dose ampicillin-sulbactam (up to 27 g/day) in combination with another active agent

  2. (cefiderocol, polymyxin B, minocycline, tigecycline)

  3. Sulbactam-durlobactam

 Oral (PO)

  1. FQ (ciprofloxacin, levofloxacin)


Intravenous (IV)

  1. Carbapenem (meropenem, imipenem-cilastatin)

  2. Aztreonam (not CR/MBL in combination with avibactam)

  3. Aminoglycoside (tobramycin, amikacin)

  4. Ceftolozane-tazobactam (CR infection)

  5. Ceftazidime-avibactam (CR infection)

  6. Imipenem-cilastatin-relebactam (CR infection)

  7. Cefiderocol (CR/MBL/MDR infection)

  8. Colistin/polymyxin B (MDR infection)

Abbreviations: ESBL-E (extended-spectrum beta-lactamase-producing Enterobacterales); cIAI (complicated intra-abdominal infection); CR (carbapenem-resistant); CRAB (carbapenem-resistant Acinetobacter baumannii); CRE (carbapenem-resistant Enterobacterales); CTX-M (cefotaxime-hydrolyzing beta-lactamase isolated in Munich); DTR (difficult-to-treat resistance); g/day (grams per day); GES (Guiana-Extended-Spectrum); IMI (imipenem-hydrolyzing beta-lactamase); IV (intravenously); KPC (Klebsiella pneumoniae carbapenemase); MBL (metallo-β-lactamase); MDR (multi-drug resistant); OXA (oxacillinase); PO (by mouth); Psa (Pseudomonas); SHV (sulfhydryl reagent variable); SME (Serratia marcescens enzymes); TMP-SMX (trimethoprim-sulfamethoxazole); VIM (verona integron-encoded metallo-β-lactamase).