An infection caused by an extended-spectrum beta-lactamase (ESBL) producing bacteria can be difficult to treat. Inappropriate antibiotic therapy can be fatal for the patient.



(1) positive for beta-lactamase

(2) multi-drug resistance (but less than extreme drug resistance)


Resistance is seen to therapy with:

(1) all penicillins

(2) all cephalosporins (except cephamycins)

(3) variable to fluoroquinolones

(4) variable to trimethroprim-sulfamethoxazole

(5) variable to aminoglycosides



(1) Perform antibiotic susceptibility testing on all isolates.

(2) Initial therapy may include a carbapenem (ertapenem). A beta-lactam combined with a beta-lactamase inhibitor may work but response is variable.

(3) The response of the patient to therapy needs to be carefully monitored.


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