Cystitis: nitrofurantoin, fosfomycin
Complicated UTI or pyelonephritis AND confirmed susceptibility: sulfamethoxazole/trimethoprim, ciprofloxacin, levofloxacin
Infection outside of the urinary tract: meropenem
Cystitis AND confirmed susceptibility:
Complicated UTI or pyelonephritis: meropenem
Infections outside of the urinary tract: ceftolozane/tazobactam
If confirmed susceptibility:
Gram-negative rods
See individual organisms
ESBLs vs. AmpC: Most ESBLs are plasmid-encoded, whereas AmpCs are usually inducible and chromosomal
In the lab, ESBLs test susceptible to cefoxitin and may be inhibited by beta-lactamase inhibitors in vitro