Treatment of CRE

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The page below is a sample from the LabCE course Drug-Resistant Superbugs, Multi-drug Resistant Organisms: MRSA, VRE, Clostridioides difficile, and CRE. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about Drug-Resistant Superbugs, Multi-drug Resistant Organisms: MRSA, VRE, Clostridioides difficile, and CRE (online CE course)
Treatment of CRE

Treatment options for CRE typically include a limited selection of antimicrobial agents, often combined with polymyxin (e.g., colistin, polymyxin B). Antimicrobial agents used include:
  • Polymyxins
  • Tigecycline
  • Minocycline
  • Aminoglycosides (except tobramycin)
  • Fosfomycin
  • Ceftazidime/avibactam (class A producers only)
CLSI also notes that patients with infections caused by organisms with a MIC for carbapenems in the intermediate range have limited treatment options. For this reason, they point to literature reports suggesting that clinicians use the maximum recommended doses, possibly for longer periods of time via intravenous infusion.