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Writer's pictureMark Nguyen, PharmD, BCEMP

Extended-Spectrum Beta-Lactamase - #PHARMFAX

Extended-spectrum beta-lactamase organisms hydrolyze penicillins, cephalosporins, and aztreonam.

 

Extended-spectrum beta-lactamase organisms hydrolyze penicillins, cephalosporins, and aztreonam. Bacteria with ESBL are defined by resistance to expanded-spectrum cephalosporins.

Gram negative rods have continued to mutate into an expansive list of beta-lactamase strains. The Ambler Classification divides them into groups, which I’ve listed above. Groups B-D are expanded resistance mechanisms of ESBL within Group A.

We know ESBL means non-beta lactams antibiotics can be considered. Carbapenems are preferred for invasive ESBL infections due to better outcomes compared to other agents. Carbapenems include ertapenem, meropenem, doripenem, and imipenem. Ertapenem does not cover Acinetobacter, Pseudomonas/Providencia, and Enteroccocus.

Tigecycline, considered a glyclcycline, is also used for ESBL-producing Enterbactericae. SMX-TMP and fluoroquinolones . Nitrofurantoin and fosfomycin are also available oral but limited to use for UTIs. Infectious Disease gets a lot more complex with limited options for carbapenem resistant enterobactericae and pseudomonas. Did you share the #PHARMFAX? Check out another video on my page, and I hope you learned something new.

Recommended Read/Watch

IV/PO ABX: PsA - https://tinyurl.com/3zx6864b

UTI ABX: https://tinyurl.com/yf48ysar

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