Spectrum: Local Antimicrobial Stewardship, for Prisma Health-Midlands

Antimicrobial Resistance

Extended-Spectrum Beta-Lactamase Producing Organisms (ESBL)

Risk Factors

  • Documentation of prior infections or colonization with ESBL producing organisms in the past 12 months

  • Receipt of multiple courses of beta-lactam and fluoroquinolone antibiotics in the past 90 days

Preferred therapy for high risk patients is meropenem.

Meropenem

CRE or MDR Pseudomonas aeruginosa

Definitions

CRE
Carbapenem-resistant Enterobacteriaceae

MDR Pseudomonas aeruginosa
Multi-drug resistant Pseudomonas aeruginosa

Risk Factors

  • Documentation of prior infections or colonization with CRE or MDR P. aeruginosa in the past 12 months

  • Receipt of ≥7 days of carbapenems in the past 90 days

Combination therapy is preferred for high risk patients

Please consult Antimicrobial Stewardship and Support Team (ASST) during business hours or an infectious diseases specialist for optimal empirical antimicrobial therapy