Difficult-to-treat resistance (DTR)

Difficult-to-treat resistance is a recently proposed category defined as nonsusceptibility to all first-line antibiotic agents.

This clinically used term is not clearly defined and accepted. It may be used in a regional or local context to describe or guide antibiotic usage protocols.

Video definition by Gavin Barlow, Hull York Medical School (UK).

Impact of difficult-to-treat resistance in gram-negative bacteraemia on mortality: retrospective analysis of nationwide surveillance data (Clinical Infectious Diseases, 2020)

External validation of difficult-to-treat resistance prevalence and mortality risk in gram-negative bloodstream infection using electronic health record data from 140 US Hospitals (Open Forum Infectious Diseases, 2019)