Cheat sheet for common resistant pathogens. Caveat: take drug penetration, allergies, concomitant medications, and local susceptibility into account.
| Organism | Empiric antibiotics |
|---|---|
| MRSA | Vancomycin (target AUC 400–600), Daptomycin (NOT for PNA), Linezolid (good for PNA, IV→PO), Ceftaroline |
| VRE | Daptomycin (high-dose 8–10 mg/kg), Linezolid |
| ESBL E. coli / Klebsiella | Carbapenem (meropenem, ertapenem). Avoid pip-tazo for severe ESBL infections (MERINO trial). |
| AmpC (Enterobacter, Serratia, Citrobacter, Providencia, Morganella, Hafnia) | Cefepime; carbapenem if severe. Avoid 3rd-gen cephalosporins (ceftriaxone) — inducible resistance. |
| CRE (carbapenem-resistant Enterobacterales) | Ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol. Call ID. |
| MDR Pseudomonas | Ceftolozane-tazobactam, ceftazidime-avibactam, cefiderocol. Call ID. |
| Stenotrophomonas maltophilia | TMP-SMX (first-line). Levofloxacin or minocycline as alternatives. |
Adapted from UCSF CODA Bugs & Drugs (Karandikar & Rubio, 2026) and IDSA antimicrobial stewardship resources.