Reference use only — Susceptibility patterns are general guidance based on common patterns and current literature. Always confirm with local antibiogram and culture sensitivities. Always check organism-specific notes and local guidelines before prescribing.

Last updated: 9/27/2026

IDSA posted version 5.0 of its AMR gram-negative guidance on July 30, 2026 (Clin Infect Dis, Aug 8). These are the main changes to the chart:

• S. maltophilia: cefiderocol monotherapy is now preferred. TMP-SMX drops from P to an alternative, used only as part of combination therapy. Levofloxacin rises to alternative. Eravacycline, omadacycline and ceftazidime are "not suggested."
• CRAB: sulbactam-durlobactam with imipenem or meropenem is the preferred treatment, and the chart has no column for it. Minocycline and polymyxin B are alternatives in combination.
• KPC: meropenem-vaborbactam and imipenem-relebactam join ceftazidime-avibactam as preferred. Resistance emerges on therapy in about 10% of ceftazidime-avibactam cases vs <3% for the other two.
• NDM/MBL: aztreonam-avibactam and cefiderocol are both preferred.
• ESBL: cephamycins are not suggested. Piperacillin-tazobactam is newly acceptable for non-severe cUTI. Ertapenem is preferred for Klebsiella as well as E. coli.
• AmpC (E. cloacae, K. aerogenes, C. freundii, now also Hafnia alvei): cefepime is the suggested agent. Ceftolozane-tazobactam is not suggested.
• P. aeruginosa: when the isolate is susceptible, traditional β-lactams (cefepime, ceftazidime, piperacillin-tazobactam, aztreonam) are preferred over carbapenems.

Disclaimer: This antibiotic coverage table is a simplified qualitative reference intended for educational and quick-reference use. Coverage patterns, resistance rates, formulary availability, and preferred treatment strategies vary by institution, patient population, and local antibiogram. Always verify recommendations against current clinical guidelines, institutional protocols, microbiology data, and infectious diseases expertise when appropriate. This table is a reference aid and is not a substitute for clinical judgment.

References: The Sanford Guide to Antimicrobial Therapy (current edition), Johns Hopkins ABX Guide (current edition), Infectious Diseases Society of America (IDSA) clinical practice guidelines, Lexicomp Online antimicrobial monographs, and institutional antimicrobial stewardship resources.

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