cefepime + ertapenem + vancomycin

This is a combination of three intravenous antibiotics—cefepime, ertapenem, and vancomycin—used together for the empiric or targeted treatment of severe or resistant bacterial infections.

• Cefepime is a fourth-generation cephalosporin with broad-spectrum activity against Gram-positive and Gram-negative bacteria, including Pseudomonas aeruginosa. It is stable against many beta-lactamases and often used in hospital-acquired infections.
• Ertapenem is a carbapenem antibiotic effective against many Gram-positive and Gram-negative organisms (including ESBL producers), but notably lacks activity against Pseudomonas and Acinetobacter. Its main advantage is once-daily dosing.
• Vancomycin is a glycopeptide antibiotic primarily active against Gram-positive bacteria, especially methicillin-resistant Staphylococcus aureus (MRSA) and other resistant staphylococci. It inhibits cell wall synthesis by binding to D-Ala-D-Ala termini of peptidoglycan precursors.
  The combination may be used in critically ill patients when broad-spectrum coverage—including MRSA, ESBL-producing Enterobacteriaceae, anaerobes, and other multidrug-resistant organisms—is required before pathogen identification or susceptibility results are available. This regimen provides overlapping but complementary mechanisms targeting cell wall synthesis at different sites.