Contents

Search

extended spectrum beta lactamase (ESBL)

In reference to bacteria that produce beta-lactamase(s) resistant to extended spectrum antibiotics. Epidemiology: - Enterobacteriaceae with carbapenemases decreased more from 2006-1015 than the extended spectrum beta lactamase phenotype [3] Management: - carbapenems are appropriate for empiric therapy of infections due to extended spectrum beta-lactamase producing gram-negative bacteria - ventilator-associated pneumonia[1] - piperacillin tazobactam (Zosyn) inferior to meropenem [4] - maintain contact precautions throughout hospitalization after 1st detected [2] - oral ciprofloxacin (if susceptible) acceptable step-down therapy [1]

Related

antibiotic resistance

General

beta lactamase

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2021. - Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025
  2. Banach DB, Bearman G, Barnden M et al Duration of Contact Precautions for Acute-Care Settings. Infection Control & Hospital Epidemiology. Jan 11, 2018 PMID: 29321078 https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/duration-of-contact-precautions-for-acutecare-settings/94E38FDCE6E1823BD613ABE4E8CB5E56
  3. Woodworth KR, Walters MS, Weiner LM, et al. Vital Signs: Containment of Novel Multidrug-Resistant Organisms and Resistance Mechanisms - United States, 2006-2017. MMWR Morb Mortal Wkly Rep. ePub: 3 April 2018. https://www.cdc.gov/mmwr/volumes/67/wr/mm6713e1.htm
  4. Harris PNA, Tambyah PA, Lye DC et al Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance. A Randomized Clinical Trial. JAMA. 2018;320(10):984-994. Sept 11, 2018 PMID: 30208454 https://jamanetwork.com/journals/jama/fullarticle/2702145 - Hayden MK, Won SY. Carbapenem-Sparing Therapy for Extended-Spectrum beta-lactamase- producing E coli and Klebsiella pneumoniae Bloodstream Infection: The Search Continues. JAMA. 2018;320(10):979-981. Sept 11, 2018 PMID: 30208439 https://jamanetwork.com/journals/jama/fullarticle/2702126