Expert Perspectives on the Diagnosis and Management of Multidrug-Resistant Gram-Negative Infections: Findings from a Cross-Sectional Survey of Indian Clinicians
Department of Medical Services, Micro Labs Limited, Bangalore, Karnataka, India
*Corresponding author
Abstract:
To assess clinical practice patterns in the diagnosis and management of multidrug-resistant Gram-negative bacterial (MDR-GNB) infections among clinicians in India, including microbiological diagnosis, empirical antibiotic selection, antimicrobial stewardship practices, usage of ceftazidime + avibactam, and clinicians' perceptions of its efficacy, safety, and clinical outcomes. This nationwide, cross-sectional, questionnaire-based survey was conducted among practicing clinicians across India. A structured 23-item multiple-choice questionnaire evaluated microbiological diagnostic practices, empirical antibiotic selection, antimicrobial stewardship, prescribing patterns of ceftazidime + avibactam, and clinicians' perceptions of its efficacy, safety, and clinical outcomes. Participation was voluntary with written informed consent. Responses were analyzed descriptively and are presented as frequencies and percentages. Among the 94 clinicians who participated in the survey, approximately 64% identified Klebsiella pneumoniae as the most frequently encountered Gram-negative pathogen. About 54% of respondents reported urinary tract infections as the most common source of MDR infections. Most clinicians (90.43%) preferred blood, urine, or sputum cultures for the identification of MDR organisms. The majority (71.28%) preferred carbapenems as empirical therapy for suspected MDR infections. Compared with colistin-based regimens, approximately 70% considered ceftazidime + avibactam to provide superior efficacy and safety. More than half (51.06%) of clinicians agreed that ceftazidime + avibactam should be used as first-line therapy for confirmed Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Enterobacteriaceae (CRE). Most respondents (60.64%) reported routinely monitoring patients for potential adverse effects or complications associated with ceftazidime + avibactam therapy. The survey highlights current clinical practice patterns in the management of MDR Gram-negative infections, emphasizing the predominance of Klebsiella pneumoniae, culture-guided diagnosis, and the use of carbapenems as empirical therapy. Clinicians perceived ceftazidime + avibactam as an effective and safe treatment option for CRE infections, supporting its growing role in antimicrobial stewardship and improving clinical outcomes.
Keywords:
MDR Gram-negative infections; Klebsiella pneumoniae; ceftazidime + avibactam; carbapenems; antimicrobial stewardship; clinical outcomes
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How to cite this article:
Manjula S. and Krishna Kumar M. 2026. Expert Perspectives on the Diagnosis and Management of Multidrug-Resistant Gram-Negative Infections: Findings from a Cross-Sectional Survey of Indian Clinicians.
Int.J.Curr.Microbiol.App.Sci.
15(8): 37-45
doi:
https://doi.org/10.20546/ijcmas.2026.1508.005
Citations
National Academy of Agricultural Sciences (NAAS) 
