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Am Fam Physician. 2024;110(2):207-209

 This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

KEY POINTS FOR PRACTICE

• Complicated UTIs caused by resistant Enterobacterales can be treated with TMP/SMX, ciprofloxacin, or levofloxacin. Nitrofurantoin and TMP/SMX are recommended for uncomplicated cystitis.

• Primary treatment of infections due to ESBL-producing Enterobacterales that occur outside the urinary tract is carbapenems.

• Primary treatment of infections due to CRE that occur outside the urinary tract is medication that combines beta-lactams and beta-lactamase inhibitors.

• Primary treatment of Pseudomonas aeruginosa infections with difficult-to-treat resistance includes ceftolozane/tazobactam, ceftazidime/avibactam, imipenem/cilastatin/relebactam, or cefiderocol.

From the AFP Editors

Antimicrobial resistance is a global crisis, and resistant pathogens cause more than 2.8 million infections and 35,000 deaths annually. Even when bacterial cultures indicate resistance, choosing the most effective antibiotic can be challenging. The Infectious Diseases Society of America published guidelines for treating infections with the most common resistant gram-negative organisms. These guidelines do not apply to empiric treatment.

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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, Assistant Medical Editor.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.

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