{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:00:34Z","timestamp":1793066434323,"version":"4.5.0"},"reference-count":112,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T00:00:00Z","timestamp":1580860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Extended spectrum \u03b2-lactamase (ESBL)-producing bacteria are prevalent worldwide and correlated with hospital infections, but they have been evolving as an increasing cause of community acquired infections. The spread of ESBL constitutes a major threat for public health, and infections with ESBL-producing organisms have been associated with poor outcomes. Established therapeutic options for severe infections caused by ESBL-producing organisms are considered the carbapenems. However, under the pressure of carbapenem overuse and the emergence of resistance, carbapenem-sparing strategies have been implemented. The administration of carbapenem-sparing antibiotics for the treatment of ESBL infections has yielded conflicting results. Herein, the current available knowledge regarding carbapenem-sparing strategies for ESBL producers is reviewed, and the optimal conditions for the \u201cwhen and how\u201d of carbapenem-sparing agents is discussed. An important point of the review focuses on piperacillin\u2013tazobactam as the agent arousing the most debate. The most available data regarding non-carbapenem \u03b2-lactams (i.e., ceftolozane\u2013tazobactam, ceftazidime\u2013avibactam, temocillin, cephamycins and cefepime) are also thoroughly presented as well as non \u03b2-lactams (i.e., aminoglycosides, quinolones, tigecycline, eravacycline and fosfomycin).<\/jats:p>","DOI":"10.3390\/antibiotics9020061","type":"journal-article","created":{"date-parts":[[2020,2,6]],"date-time":"2020-02-06T02:59:18Z","timestamp":1580957958000},"page":"61","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":137,"title":["Carbapenem-Sparing Strategies for ESBL Producers: When and How"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2226-0239","authenticated-orcid":false,"given":"Ilias","family":"Karaiskos","sequence":"first","affiliation":[{"name":"Department of Internal Medicine-Infectious Diseases, Hygeia General Hospital, 15123 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Giamarellou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine-Infectious Diseases, Hygeia General Hospital, 15123 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1093\/jtm\/taw102","article-title":"The ecology of extended-spectrum \u03b2-lactamases (ESBLs) in the developed world","volume":"2017","author":"Doi","year":"2017","journal-title":"J. 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