the patient transferred to Gynae ward on empirical I.V ampicillin-sulbactam. The patient remains febrile with only a slightly clinical improvement. On day two, the laboratory reports in urine hematuria, 500 leucocytes per µL and an Escherichia coli isolate [105 CFU/mL] with the phenotype presented below. The MIC values were obtained with an automated system (only fosfomycin and colistin were tested with the Etest) and interpreted according to the current CLSI and EUCAST criteria. Furthermore,. phenotypic tests (i.e., synergy with clavulanate) also indicate that the E. coli isolate is not an extended-spectrum β-lactamase (ESBL) producer. ANTIMICROBIALS TESTED CLSI 2012 EUCAST 2012
Ampicillin (≥32 mg/L) R R
Amoxicillin-clavulanate (≥32 mg/L) R R
Piperacillin (64 mg/L) I R
Piperacillin-tazobactam (16 mg/L) S I
Ampicillin-sulbactam (16 mg/L) I R
Cephalotin (≥32 mg/L) R Not available
Cefoxitin (≥64 mg/L) R Not available
Cefuroxime p.o. (≥64 mg/L) R R
Cefuroxime i.v. (≥64 mg/L) R R
Ceftriaxone (2 mg/L) I I
Cefotaxime (2 mg/L) I I
Ceftazidime (8 mg/L) I R
Cefepime (≤1 mg/L) S S
Imipenem (0.25 mg/L) S S
Meropenem (≤0.25 mg/L) S S
Ertapenem (0.5 mg/L) S S
Aztreonam (8 mg/L) I R
Gentamicin (8 mg/L) I R
Amikacin (4 mg/L) S S
Trimethoprim/sulfamethoxazole (≥320 mg/L) R R
Ciprofloxacin (1 mg/L) R I
Nitrofurantoin (8 mg/L) S S
Fosfomycin (64 mg/L) S R
Colistin (0.5 mg/L) Not available S
The patient does not have renal or hepatic impairments, and her BMI is within normal values. What would you use for the directed treatment of the above case
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