Antimicrobial Treatmdent of

Table 5 Calculated and targeted antibiotic therapy with suspected or proven IAI with multi-resistant agents

Agent	Antibiotic	Level of evidence	Strength of recommendation
MRSA	Tigecycline#	2	A
	Linezolid+	3	A
	Daptomycin+	4	C
	Vancomycin+	4	B
	Cotrimoxazole+	4	C
VRE	Tigecycline#	2	A
	Linezolid+	3	A
ESBL-producing (E. coli, Klebsiella spp.)	Imipenem	3	A
	Meropenem	3	A
	Doripenem	3	A
	Ertapenem#	3	A
	Tigecycline#	2	A
	Acylaminopenicillin/BLI	3	A
	Fosfomycin◊	4	B
Pseudomonas spp.	Imipenem	4	A
	Meropenem	4	A
	Doripenem	4	A
	Acylaminopenicillin/BLI	4	A
	Cefepim	4	A
	Aminoglycoside◊	4	B
	Ciprofloxacin*	4	A
	Levofloxacin*	4	A
Acinetobacter spp.	Colistin	2	A
	Tigecycline#	4	A
Carbapenemase-producing (i.e. KPC)species	Tigecycline#	4	A
	Colistin	4	B

(MRSA = Methicillin resistant S. aureus, VRE = Vancomycin-resistant Enterococcus spp., ESBL = extended spectrum beta-lactamase producing species, + = Combination with antibiotics covering gram negative and anaerobic species required, # = Combination with Pseudomonas-active antibiotics required if Pseudomonas is suspected; ◊ = no monotherapy, * = use antibiotic only if local susceptibility rates are ≥ 90%.

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