The Infectious Diseases Society of America (IDSA) recently released updated guidance regarding treating antimicrobial-resistant (AMR) infections. The guidance provides recommendations for clinicians on treating infections caused by resistant bacteria, which are commonly encountered in U.S. hospitals and often result in significant morbidity and mortality.

The new document is the fourth updated guidance document and focuses on infections caused by AMR Gram-negative bacteria, including extended-spectrum β-lactamase–producing Enterobacterales, AmpC β-lactamase–producing Enterobacterales, carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa with difficult-to-treat resistance, carbapenem-resistant Acinetobacter baumannii, and Stenotrophomonas maltophilia. The CDC has designated many of these pathogens as urgent or serious threats.

The IDSA also noted that due to differences in the epidemiology of AMR and the availability of specific anti-infectives internationally, this document focuses on treating AMR infections in the United States.

The panel of experts indicated that the updated guidance contains the preferred and alternative suggested treatment approaches with accompanying rationales for the recommended treatment section, assuming the causative organism has been identified and antibiotic susceptibility results are established.

The panel noted that the guidance is presented in the form of answers to a series of clinical questions for each pathogen. Although brief descriptions of notable clinical trials, resistance mechanisms, and antimicrobial susceptibility testing methods are included, the document does not provide a comprehensive review of these topics. GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology is not employed. Approaches to empiric treatment, shifting to oral therapy, duration of therapy, and other management considerations are briefly discussed.

The experts wrote, “The field of AMR is dynamic and rapidly evolving, and the treatment of AMR infections will continue to challenge clinicians. As newer antibiotics against resistant pathogens are incorporated into clinical practice, we are learning more about their effectiveness and propensity to resistance.”

This treatment guidance will be updated approximately annually.

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