TABLE 2.

Recommended intravenous antibiotic treatment options for extended-spectrum β-lactamase producing Enterobacterales.^†,^‡,^§

Source	Preferred treatment	Alternative treatment§§
Pyelonephritis or complicated UTI¶
	Aminoglycosides or Fluoroquinolones (ciprofloxacin, levofloxacin) or Piperacillin-tazobactam†† or Ertapenem	Meropenem or Imipenem-cilastatin
Infections outside of the urinary tract
Complicated intra-abdominal infections	Tigecycline or Piperacillin-tazobactam†† or Ertapenem	Meropenem or Imipenem-cilastatin
Pneumonia	Piperacillin-tazobactam†† or Ertapenem	Meropenem or Imipenem-cilastatin
Bloodstream infections	Aminoglycosides‡‡ or Ertapenem	Meropenem or Imipenem-cilastatin

UTI, urinary tract infections; BLIC, β-lactamase inhibitor combinations; MIC, minimum inhibitory concentration.

^†, Assuming in vitro susceptibility to agents in the table.

^‡, Refer to Table 5 for recommended dosing and administration schedules for adult critically ill patients with normal renal function.

^§, From a strategic point-of-view, ceftazidime-avibactam and ceftolozane-tazobactam are not recommended for extended-spectrum β-lactamase producing Enterobacterales infections.

^¶, Complicated UTI, is defined as ‘UTI that occurs in association with a structural or functional abnormality of the genitourinary tract, or any UTI in a male patient’. This excludes UTIs in catheterised patients or caused by a resistant bacterium.

^††, Only if MIC ≤ 4.

^‡‡, If extended-spectrum β-lactamase producing Enterobacterales bloodstream infection is secondary to urinary source.

^§§, If 1st line options are not susceptible, not available or tolerated or in cases of confirmed bacteriological and clinical failure.