• Shannon Holt, Mollie Grant, and Kelly A Thompson-Brazill.
• Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist, infectious disease, Department of Pharmacy, WakeMed Health & Hospitals, Raleigh, North Carolina. Mollie Grant is a critical care pharmacy specialist, WakeMed Health & Hospitals, Raleigh, North Carolina. Kelly A. Thompson-Brazill is an assistant professor, Georgetown University School of Nursing and Health Studies, Washington, DC.
• Crit Care Nurse. 2017 Oct 1; 37 (5): 78-84.

AbstractCatheter-associated urinary tract infections are one of the most common sources of infection, accounting for up to 40% of health care-associated infections each year in the United States. Extended-spectrum β-lactamase-producing Enterobacteriaceae are frequent causes of urinary tract infections in health care settings. Prevalent use of carbapenems has led to the emergence of carbapenem-resistant Enterobacteriaceae infections, leaving clinicians with few treatment options. Reducing carbapenem use and investigating alternative options for low-severity extended-spectrum β-lactamase infections is imperative to prevent more cases of carbapenem-resistant Enterobacteriaceae. Although carbapenems are the antibiotics of choice for treating extended-spectrum β-lactamase-producing Enterobacteriaceae catheter-associated urinary tract infections, carbapenem-sparing regimens may be appropriate for treating hemodynamically stable patients with low inoculum levels. Moreover, frontline health care providers can initiate efforts to reduce the development of multidrug-resistant organisms by decresing inappropriate antibiotic use during the treatment of catheter-associated asymptomatic bacteruria, avoiding unnecessary catheterizations, and avoiding culturing urine in asymptomatic patients.©2017 American Association of Critical-Care Nurses.

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