Apex Infectious Disease · Team education

IDSA 2026 resistant gram-negative review

Two self-scoring question sets built from the IDSA 2026 guidance on treating antimicrobial-resistant gram-negative infections. Each question opens its rationale after you answer, with the specific guidance question cited. Nothing is recorded — answers stay in your own browser.

Source: IDSA 2026 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections, version 5.0
Currency: Content current as of 1 March 2026; posted 30 July 2026; Clin Infect Dis 8 Aug 2026
Running time: 45–60 minutes per set, or filter to one organism for a short huddle

Part 1

Resistant Enterobacterales

General management, ESBL-producing and AmpC-producing Enterobacterales, and CRE urinary infection. Start here — it carries the principles the second set assumes.

26 questions · Sections 1–3.2 Part 2

Nonfermenters & carbapenemases

Carbapenemase-directed therapy for invasive CRE, DTR Pseudomonas aeruginosa, carbapenem-resistant Acinetobacter, and Stenotrophomonas maltophilia.

25 questions · Sections 3.3–6

Four answers that changed in version 5.0

Worth knowing before you start if you trained on the 2024 guidance — these are the items where confident recall is most likely to be wrong.

Stenotrophomonas maltophilia: Cefiderocol monotherapy is now preferred. TMP-SMX, minocycline, and levofloxacin are alternatives, and only as components of combination therapy. The panel notes this preference rests largely on neutropenic animal models and PK/PD rather than clinical outcome studies.
NDM-producing Enterobacterales: Aztreonam-avibactam is now a preferred agent alongside cefiderocol. Ceftazidime-avibactam plus aztreonam drops to the fallback for when aztreonam-avibactam is unavailable.
KPC-producing Enterobacterales: The panel now states a mild preference order — meropenem-vaborbactam, then ceftazidime-avibactam, then imipenem-relebactam — driven partly by resistance emergence of roughly 10% with ceftazidime-avibactam versus under 3% with the other two.
Carbapenem-resistant Acinetobacter: High-dose ampicillin-sulbactam is now framed as temporary bridging therapy only, until sulbactam-durlobactam plus a carbapenem can be started.