AmpC β-Lactamase Treatment Guidelines

Introduction to AmpC β-Lactamase

The World Society of Emergency Surgery recommends cefepime as a carbapenem-sparing alternative for treating AmpC-producing organisms, with substantial clinical evidence showing its stability against AmpC hydrolysis 1
The 2023 World Society of Emergency Surgery guidelines express concern about the use of piperacillin/tazobactam in AmpC contexts and recommend against its use for ESBL infections 2

For severe infections caused by inducible AmpC producers, the World Society of Emergency Surgery recommends carbapenems (meropenem, imipenem, ertapenem) as the safest choice, with cefepime as a carbapenem-sparing alternative 1
Cefepime must be combined with metronidazole for intra-abdominal infections due to its lack of anaerobic coverage 1
Ceftolozane/tazobactam is an option that preserves activity against AmpC producers, according to the 2023 World Society of Emergency Surgery guidelines 2

The World Society of Emergency Surgery emphasizes the importance of carbapenem-sparing strategies, given the global crisis of carbapenem resistance, and recommends reserving carbapenems for severe infections or when cefepime fails 2
Cefepime is the primary carbapenem-sparing option for AmpC producers, with substantial clinical evidence supporting its use 1