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

From: Antimicrobial Treatmdent of "Complicated" Intra-Abdominal Infections and The New IDSA Guidelines - A Commentary and an Alternative European Approach According to Clinical Definitions

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

  1. (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%.