{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:24:57Z","timestamp":1792301097982,"version":"4.4.0"},"reference-count":398,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T00:00:00Z","timestamp":1522540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Microbiol Rev"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    Therapy of invasive infections due to multidrug-resistant\n                    <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n                    (MDR-E) is challenging, and some of the few active drugs are not available in many countries. For extended-spectrum \u03b2-lactamase and AmpC producers, carbapenems are the drugs of choice, but alternatives are needed because the rate of carbapenem resistance is rising. Potential active drugs include classic and newer \u03b2-lactam\u2013\u03b2-lactamase inhibitor combinations, cephamycins, temocillin, aminoglycosides, tigecycline, fosfomycin, and, rarely, fluoroquinolones or trimethoprim-sulfamethoxazole. These drugs might be considered in some specific situations. AmpC producers are resistant to cephamycins, but cefepime is an option. In the case of carbapenemase-producing\n                    <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n                    (CPE), only some \u201csecond-line\u201d drugs, such as polymyxins, tigecycline, aminoglycosides, and fosfomycin, may be active; double carbapenems can also be considered in specific situations. Combination therapy is associated with better outcomes for high-risk patients, such as those in septic shock or with pneumonia. Ceftazidime-avibactam was recently approved and is active against KPC and OXA-48 producers; the available experience is scarce but promising, although development of resistance is a concern. New drugs active against some CPE isolates are in different stages of development, including meropenem-vaborbactam, imipenem-relebactam, plazomicin, cefiderocol, eravacycline, and aztreonam-avibactam. Overall, therapy of MDR-E infection must be individualized according to the susceptibility profile, type, and severity of infection and the features of the patient.\n                  <\/jats:p>","DOI":"10.1128\/cmr.00079-17","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T06:46:27Z","timestamp":1518504387000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":609,"title":["Treatment of Infections Caused by Extended-Spectrum-Beta-Lactamase-, AmpC-, and Carbapenemase-Producing Enterobacteriaceae"],"prefix":"10.1128","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-9001","authenticated-orcid":false,"given":"Jes\u00fas","family":"Rodr\u00edguez-Ba\u00f1o","sequence":"first","affiliation":[{"name":"Unidad Cl\u00ednica de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario Virgen Macarena\/Universidad de Sevilla\/Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Guti\u00e9rrez-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario Virgen Macarena\/Universidad de Sevilla\/Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Machuca","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Enfermedades Infecciosas, Hospital Universitario Reina Sof\u00eda\/IMIBIC, C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Pascual","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario Virgen Macarena\/Universidad de Sevilla\/Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","volume-title":"A call to narrow the gap between multidrug-resistant bacteria in the EU and the development of new antibacterial agents","author":"ECDC\/EMEA","year":"2009","unstructured":"ECDC\/EMEA. 2009. 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