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Acinetobacter species: Antimicrobial categories and agents used to define MDR, XDR, CR, and PDR

Acinetobacter species: Antimicrobial categories and agents used to define MDR, XDR, CR, and PDR
Antimicrobial category Antimicrobial agent
Aminoglycosides Gentamicin
Tobramycin
Amikacin
Netilmicin*
Antipseudomonal carbapenems Imipenem
Meropenem
Doripenem
Antipseudomonal fluoroquinolones Ciprofloxacin
Levofloxacin
Antipseudomonal penicillins + beta-lactamase inhibitors Piperacillin-tazobactam
Ticarcillin-clavulanic acid*
Extended-spectrum cephalosporins Cefotaxime
Ceftriaxone
Ceftazidime
Cefepime
Folate pathway inhibitors* Trimethoprim-sulphamethoxazole
Penicillins + beta-lactamase inhibitors Ampicillin-sulbactam
Polymyxins* Colistin
Polymyxin B
Tetracyclines* Tetracycline
Doxycycline
Minocycline
Criteria for defining MDR, XDR, CR, and PDR in Acinetobacter spp:
  • MDR: Non-susceptible to ≥1 agent in ≥3 antimicrobial categories*
  • XDR: Non-susceptible to ≥1 agent in all but ≤2 categories
  • CR: Non-susceptible to ≥1 antipseudomonal carbapenem
  • PDR: Non-susceptible to all antimicrobial agents listed
This terminology and these criteria were created by a group of international experts as part of a joint initiative by the European Centre for Disease Prevention and Control (ECDC) and the United States Centers for Disease Control and Prevention (CDC). The criteria for MDR were updated in 2022 by the CDC.

MDR: multidrug resistant; XDR: extensively drug resistant; CR: carbapenem resistant; PDR: pandrug resistant.

* These agents are not included in the definition of MDR.
Original figure modified for this publication. From: Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012; 18:268. Table used with the permission of Elsevier Inc. All rights reserved.
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