Meropenem or ertapenem
If confirmed susceptible:
Gram negative rods
Normal GI flora that have a plasmid encoding ESBL
Infections commonly nosocomial, but may be community-acquired, especially in patients with recent antimicrobial exposure
Can also be acquired from environment/water, surfaces, animals, and meat
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