MDR Bacterial Infections Our Treatment Option

Recommended Definite Therapy for Serious Infections Causedby Drug-resistant Gram-negative BacteriaCarbapenem-resistant A. baumannii• Colistin as for carbapenemase-producing Enterobacteriaceae• Ampicillin-sulbactam, up to 6 g of sulbactam IV per day• Tigecycline 100-mg IV loading dose, then 50 mg IV q 12 h‡‡ This regimen would not be recommended for bloodstream infection, owing to low serum drug levels.Possible alternativesExtended infusion of carbapenem• Meropenem 1-2 g IV infusion over a 3-hr period every 8 hr• Doripenem, 500 mg- 1 g IV infusion over a 4-hr period q 8 hr• Imipenem 1 g IV infusion over a 3-hr period q 8 hCombination therapy with a nontraditional antibiotic § , including• Rifampin• Minocycline• Azithromycin• Doxycycline§Use of these antibiotics is based on in vitro data and animal models and on clinical case reports and studies of small series of patients.Peleg AY, Hooper DC. Hospital-Acquired Infections Due to Gram-Negative Bacteria . N Engl J Med 2010;362:1804-13.