8 937
订阅者
+724 小时
+497 天
+17330 天
帖子存档
🦠 IDSA 2026 AMR Gram-Negative Guidance
What's New? | July 2026
🔵 ESBL-Producing Enterobacterales (ESBL-E)
🧪 New ESBL definition
Ceftriaxone MIC ≥4 µg/mL
💊 New agents added
✅ Gepotidacin
✅ Pivmecillinam
✅ Oral sulopenem
✅ IV fosfomycin
✅ Cefepime-enmetazobactam (emerging role)
📌 Practice update
Piperacillin-tazobactam may be considered for complicated UTI (not first choice for invasive disease).
---
🟢 AmpC-Producing Enterobacterales
🦠 New organism
Hafnia alvei added as moderate-risk AmpC producer.
📌 Key updates
Continue ceftriaxone if:
Non-severe infection
Clinical improvement
Adequate source control
⚠️ Piperacillin-tazobactam appears suboptimal for invasive AmpC infections.
---
🔴 Carbapenem-Resistant Enterobacterales (CRE)
⭐ Major advance
Aztreonam-avibactam introduced for NDM-producing CRE and is slightly preferred over ceftazidime-avibactam + aztreonam.
🆕 Added:
IV fosfomycin
Gepotidacin
Pivmecillinam
🔬 Updated comparisons:
Ceftazidime-avibactam vs Meropenem-vaborbactam
Aztreonam-avibactam vs Cefiderocol
---
🟣 Difficult-to-Treat (DTR) Pseudomonas aeruginosa
🏆 Preferred for uncomplicated UTI
Single-dose amikacin or tobramycin
🫁 Pneumonia
Ceftolozane-tazobactam preferred over ceftazidime-avibactam.
💨 Nebulised antibiotics:
Still not routinely recommended, but evidence is becoming more favourable.
---
🟠 Carbapenem-Resistant Acinetobacter baumannii (CRAB)
🥇 First-line therapy
Sulbactam-durlobactam + carbapenem
⏳ Alternative regimens:
Only as bridge therapy until sulbactam-durlobactam becomes available.
If resistant:
Two active non-sulbactam agents or
Sulbactam-durlobactam + cefiderocol
---
🟡 Stenotrophomonas maltophilia
⭐ Preferred therapy
Cefiderocol monotherapy
➕ Aztreonam-avibactam added as part of combination therapy for selected invasive infections.
---
🚨 Top 6 Take-Home Messages
✅ New FDA-approved antibiotics incorporated into guidance.
✅ Aztreonam-avibactam is now preferred for NDM-producing CRE.
✅ Sulbactam-durlobactam becomes the cornerstone of invasive CRAB treatment.
✅ Ceftolozane-tazobactam is favoured for DTR Pseudomonas pneumonia.
✅ Piperacillin-tazobactam has a limited role (acceptable for some complicated ESBL UTIs but generally not for invasive AmpC infections).
✅ Updated microbiology definitions and resistance epidemiology should guide antimicrobial stewardship and empiric therapy.
> Bottom line: The 2026 IDSA guidance expands therapeutic options, emphasises newer β-lactam/β-lactamase inhibitor combinations, refines laboratory interpretation, and strengthens precision treatment based on resistance mechanisms.
https://www.idsociety.org/practice-guideline/amr-guidance/
+1Management of Staphylococcus aureus bacteremia
https://www.idsociety.org/globalassets/idsa/practice-guidelines/sab/consensus-statement-7-manuscript.pdf
Photo from Mohammed Alabdullah ID
http://www.isac-abxguide.world/
✈️🌍 Planning to Travel Soon? Stay Informed, Stay Safe :
🇸🇦Saudi Arabia Travel Health Resources:
🔹 PHA (هيئة الصحة العامة): https://www.pha.gov.sa/ar-sa/Healthportal/Pages/travel-danger.aspx
🔹 MOH Travel Clinics Guide: https://www.moh.gov.sa/awarenessplateform/SeasonalAndFestivalHealth/Documents/Travel-Clinics.pdf
🌐 International Travel Advisory Sites:
🔹 CDC Travel Notices (USA): https://wwwnc.cdc.gov/travel/notices
🔹 CDC Travel Health Portal: https://wwwnc.cdc.gov/travel
🔹 Government of Canada Travel Advisories: https://travel.gc.ca/travelling/advisories
🔹 UK Foreign Travel Advice: https://www.gov.uk/foreign-travel-advice
🔹 NHS Fit for Travel (UK): https://www.fitfortravel.nhs.uk/destinations
