ESCaPMs are resistant to most common antibiotics, and the best treament for them is not known. Current treatment guidelines recommend using meropenem, one of the most powerful antibiotics in our armamentarium and the last line of defence against antbiotic resistant bacteria. Since overuse of particular antibiotics can lead to bacterial resistance (at a community or hospital level), the use of meropenem should be minimised and limited to those cases where it is truly needed. Piperacillin/Tazobactam (pip/tazo for short) is a narrower spectrum alternative, which is active against ESCaPM bacteria in the laboratory, and although small studies suggest it is also effective in people, a randomised trial has not previously been performed to definitively answer this question.
Blood stream infection caused by bacteria known as ESCaPMs (an acronum standing for their names: Enterobacter, Serratia, Citrobacter, Providencia and Morganella) is common and promlematic, with over 45 cases at JHH annually.