Outcome of Inappropriate Empirical Treatment for Pyelonephritis with ESBL-Producing Pathogens

In an era of rapidly increasing rates of infection with extended-spectrum β-lactamase (ESBL)–producing gram-negative pathogens, patients may receive inappropriate empirical therapy unless very broad spectrum antibiotics are used, yet these antibiotics should be avoided to limit spread of resistance. Knowing how patients fare after receiving inappropriate empirical therapy would help inform the initial treatment decision. To examine this question, researchers retrospectively assessed a case series of 175 patients with pyelonephritis caused by ESBL-producing Enterobacteriales treated in a single center from 2014 through 2016. All patients were ultimately treated with appropriate antibiotics for a median of 12 days (minimum, 7 days); however, …