IDSA updates guidance for antimicrobial-resistant gram-negative infections - Scorecard - MDSpire
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IDSA updates guidance for antimicrobial-resistant gram-negative infections

"Determining how best to place and use these agents requires weighing multiple factors and is a constantly evolving science."

  • By

  • Meg Barbor

  • August 21, 2026

  • 5 min

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Clinical Scorecard: IDSA updates guidance for antimicrobial-resistant gram-negative infections

At a Glance

CategoryDetail
ConditionAntimicrobial-resistant gram-negative infections
Key MechanismsInvolves six major pathogen groups: ESBL-E, AmpC-E, CRE, DTR P. aeruginosa, CRAB, and S. maltophilia.
Target PopulationAdults and children, with specific dosing guidance for adults.
Care SettingU.S. clinical practice

Key Highlights

  • Guidance incorporates newer therapies and evolving evidence.
  • Susceptibility testing is central to treatment decisions.
  • Empiric treatment should consider infection severity and local resistance patterns.
  • Preferred therapies vary based on resistance mechanisms.
  • Newer agents expand treatment options for difficult-to-treat infections.

Guideline-Based Recommendations

Diagnosis

  • Identify the organism causing the infection and its susceptibility.

Management

  • Use carbapenems for invasive ESBL-E infections outside the urinary tract.
  • Cefepime is preferred for AmpC-E infections when susceptible.
  • Specific treatments recommended for CRE based on resistance mechanism.

Monitoring & Follow-up

  • Reassess treatment once organism and susceptibility profile are known.

Risks

  • Avoid unnecessary antibiotic use by distinguishing true infection from colonization.

Patient & Prescribing Data

Adults and children with antimicrobial-resistant gram-negative infections.

Transition from intravenous to oral therapy when clinically stable and appropriate.

Clinical Best Practices

  • Consider safety, tolerability, cost, and ease of administration when choosing antibiotics.
  • Use newer beta-lactam agents for DTR P. aeruginosa based on susceptibility testing.
  • Cefiderocol monotherapy is preferred for invasive S. maltophilia infections.

Related Resources & Content

Original Source(s)

IDSA updates guidance for antimicrobial-resistant gram-negative infections

  • by Meg Barbor

  • August 21, 2026

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