Management of Extended-Spectrum Beta-Lactamase-Positive Gram-Negative Bacterial Urologic Infections

Extended-spectrum beta-lactamases (ESBLs) are enzymes that confer increased resistance to commonly used antibiotics. The prevalence rates of ESBL producing bacteria are increasing, and the associated increase in morbidity and mortality is becoming a public health concern. ESBL producers are emerging as an important cause of urinary tract infection (UTI) and empirical therapy should therefore be carefully selected for patients with UTI. Fosfomycin or nitrofurantoin would be an appropriate choice for empirical therapy of uncomplicated UTI. Ertapenem or cefepime might be recommended for initial empirical therapy patients suspected of having complicated UTI.