[Table/Fig-3]:

Shows the current resistance patterns of gram negative bacteria in India and its implications for beta lactam drug therapy

Gram Negative Bacteria	Resistance Pattern	Antibiotics Ineffective	Role of Beta Lactam Drugs	Role of Beta Lactam/Beta Lactamase Inhibitor Combination	Prevalence of Resistance Pattern
Enterobacteriaceae + Non fermenters - E coli, Klebsiella, Citrobacter, Enterobacter, Pseudomonas, Acinetobacter	ESBL§	1st, 2nd and 3rd generation cephalosporins	1st, 2nd and 3rd generation cephalosporin resistant. Only 4th generation cephalosporin as per sensitivity pattern is sensitive. (But now % sensitivity of 4th generation cephalosporins is also poor)	Might be effective, but now % sensitivity is coming down.	23.8-63.8% for E.coli 10.1-76.2% for Klebsiella pneumoniae [28–36, 37–39] 14.4-70.5% for Proteus mirabilis [28,29,38].
	AmpC	1st, 2nd, 3rd and 4th generation cephalosporins + combination drugs	Resistant	Resistant	3.3-24.1% in E.coli isolates, [47–52] 2.2-37.5% in Klebsiella pneumoniae, [47–52,34] 37.77% among Proteus mirabilis [53].
	Carbepenamase (||MBL/**KPC)	All beta lactams, including penems	Resistant	Resistant	10-54.54% for MBL from Pseudomonas and Acinetobacter [67–71] 1-11% for Enterobacteriaceae. [72–75])

§ESBL = Extended spectrum beta lactamases

||MBL = Metallo beta lactamases

**KPC = Klebsiella pneumoniae carbapenemases