Even with a history of recurrent UTI with resistant uropathogens, empirical carbapenems are rarely needed in children with cUTI unless a child presents with sepsis (see below).93–95 If the identified uropathogen is MDR, including carbapenem-resistant, options include a carbapenem plus amikacin combination, colistin and newer B-lactam/B-lactamase antibiotics such as ceftazidime-avibactam.80,93 Since methicillin-resistant S. aureus (MRSA) is an uncommon uropathogen, this rarely needs to be covered empirically. The gene discussed is PPIB; the disease is Sepsis.