In addition to penicillins and cephalosporins, which agents should be included in antimicrobial susceptibility testing of Enterobacter infections?

Updated: Jun 18, 2019
  • Author: Susan L Fraser, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Include at least one carbapenem, usually imipenem or meropenem, in accordance with available pharmaceutical agents in the institution.

Include aminoglycosides, usually gentamicin and tobramycin. Amikacin may be tested primarily or when bacteria show resistance to these 2 drugs.

Include a quinolone, such as ciprofloxacin.

Include TMP-SMZ.

Some laboratories routinely add aztreonam.

A cephamycin, such as cefoxitin, is a useful addition to screen for some specific beta-lactamases, such as those of class C (see Medical Care).

Other antibiotics that may be considered for testing include tigecycline, eravacycline, polymyxin B, colistin, plazomicin, meropenem-vaborbactam, imipenem-cilastatin-relebactam, and ceftazidime-avibactam, especially when particularly resistant organisms are identified.


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