SPECIAL COMMENTARIESCurrent evidence for therapy of ceftriaxone-resistant Gram-negative bacteremiaPaterson, David L.a,b; Henderson, Andrewa,c; Harris, Patrick N.A.a,dAuthor Information aUniversity of Queensland Centre for Clinical Research bInfectious Diseases Unit, Royal Brisbane and Women's Hospital cInfection Management Services, Princess Alexandra Hospital dCentral Microbiology Laboratory, Pathology Queensland, Brisbane, Australia Correspondence to David L. Paterson, University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Level 8, Building 71/918, UQCCR, RBWH Campus, Herston, QLD 4029, Australia. Tel: +61 7 3346 5500; fax: +61 7 3346 5509; e-mail: email@example.com Current Opinion in Infectious Diseases: February 2020 - Volume 33 - Issue 1 - p 78-85 doi: 10.1097/QCO.0000000000000623 Buy Metrics Abstract Purpose of review This article aims to give a state-of-the-art assessment of treatment options for bloodstream infection because of ceftriaxone-resistant Gram-negative bacilli, especially those caused by extended-spectrum beta-lactamase (ESBL) or AmpC-producing Enterobacteriaceae. In particular, this review assesses whether current data support ‘carbapenem-sparing options’ for treatment of these serious infections. Recent findings The MERINO trial refuted earlier observational studies some of which showed equivalence in outcomes between beta-lactam/beta-lactamase inhibitor combinations and carbapenems for treatment of bloodstream infection because of ceftriaxone-resistant Escherichia coli or Klebsiella spp. Although numerous factors influence mortality following bloodstream infection, the variability in piperacillin/tazobactam MICs observed in the MERINO trial make this a less secure option than meropenem. However, the search for carbapenem-sparing options continues with four randomized controlled trials (RCTs) in progress and a number of other options in clinical development. Summary Hard outcomes from RCTs are still needed before intravenous carbapenems can be displaced as the treatment of choice for ceftriaxone-resistant Gram-negative bacilli. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.