Antibiotics for AmpC producing organisms? #rxshorts

🔮 AmpC-producing organisms make beta-lactam/beta-lactamase combos and most cephalosporins and penicillins ineffective.

💀 Cefepime is the exception to ineffective beta-lactams with ampC organisms. Cefepime can be utilized since it poorly induces ampC expression and miniminaly hydrolyzed by the enzyme.

🍖Carbapenems are also first-line therapy or when cefepime MIC is greater than 4 for moderate to severe infections caused by amp-C producing enterobacterales.

👐 IDSA recommends nitrofurantoin and Bactrim for uncomplicated cystitis. Single-dose aminoglycosides and fosfomycin can be considered. For complicated UTI or pyelonephritis, Bactrim and Fluoruoquinolones. Additionally, these agents can be considered as step-down oral therapy from IV regimens, when appropriate.

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