Guideline for antimicrobial treatment of multidrug-resistant Gram-negative infections: practice recommendations of the Brazilian Society of Infectious Diseases

作者：Alexandre Prehn Zavascki, Alberto Chebabo, Clóvis Arns da Cunha, Alexandre Rodrigues Silva, Gabriel Trova Cuba, Daniel Wagner de Castro Lima Santos, Ana Cristina Gales · 发表于：The Brazilian Journal of Infectious Diseases · 年份：2025 · DOI：10.1016/j.bjid.2025.104589 · 被引用次数：6 · 研究领域：Antibiotic Resistance in Bacteria、Antibiotic Use and Resistance、Antibiotics Pharmacokinetics and Efficacy

Although international guidelines are available, a national consensus is crucial to address the unique challenges faced in Brazil regarding the management of infections caused by multidrug-resistant Gram-negative bacilli (MDR-GNB). These challenges include marked regional disparities in antimicrobial access, variability in pathogen prevalence and resistance patterns, and unequal availability of diagnostic resources. This guideline, developed by a consensus of infectious diseases experts nominated by the Brazilian Society of Infectious Diseases, aims to support clinicians, particularly non-specialists, in the management of MDR-GNB infections across diverse healthcare settings in the country. The document focuses on pathogens classified as critical or high-priority by the World Health Organization (WHO), including Carbapenem-Resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPA), ESBL- and AmpC-producing Enterobacterales, as well as Stenotrophomonas maltophilia, and Burkholderia cepacia. Therapeutic recommendations are organized by pathogen and infection site, including respiratory tract, skin and soft tissue, bloodstream, intra-abdominal, and both complicated and uncomplicated urinary tract infections.