New Anaerobic Activity Index Quantifies Anti-Anaerobic Antibiotic Exposure

This study introduces a granular, susceptibility-based scoring metric that lets stewardship teams and researchers move beyond binary anti-anaerobic classification when studying microbiome-mediated harms.

Anaerobic Activity IndexAAImeropenemertapenemtigecyclinemetronidazolepiperacillin-tazobactamcefepimeanti-anaerobic antibioticsantimicrobial stewardshipspectrum scoreDASCmASIburn patientssepsisgut microbiomeobservational cohortmethodological study Infectious Disease / Antimicrobials

Background Information

A new index ranks antibiotics by anaerobic activity exposure.

Antibiotics with anaerobic activity can lead to unfavorable outcomes in burn patients, necessitating a reliable way to quantify exposure. The Anaerobic Activity Index (AAI) ranks antibiotics based on anaerobic activity, with meropenem having the highest score. Higher AAI quartiles were linked to worse outcomes (OR: 2.90; 95% CI: 1.65-5.08). The AAI provides a tool to evaluate antibiotic effects on anaerobic bacteria, though it requires updates with new data and excludes some antibiotics due to insufficient data. The Anaerobic Activity Index helps quantify exposure to anaerobic-active antibiotics, potentially influencing patient outcomes.

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Authors: Mackow NA, Komarow L, Napravnik S, Andermann TM, Bartelt L, DiBiase LM, Williams B, Williams FN, Young VB, Aronoff DM, Weber DJ, Chanderraj R, van Duin D

Citation: Mackow NA, Komarow L, Napravnik S, et al. Development and Application of an Anaerobic Activity Index. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2026. doi:10.1093/cid/ciag470

Article Links: PubMed · Journal / DOI

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Executive Summary

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