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<p>Abstract</p> <p>Background</p> <p>To examine common antimicrobial regimens used in eradicating certain nosocomial Gram-negative pathogens and determine which ones are likely to be the most suitable as empirical choices in Shenyang, China.</p> <p>Methods</p> <p>A 5000-subject Monte Carlo simulation was conducted to determine the cumulative fraction of response (CFR) for meropenem, imipenem, cefepime, piperacillin/tazobactam and levofloxacin against <it>Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii </it>and <it>Pseudomonas aeruginosa </it>collected in 2006 and 2007 from Shenyang.</p> <p>Results</p> <p>Meropenem and imipenem had the highest CFRs against the <it>Enterobacteriaceae </it>(97%-100%), followed by cefepime. No antibiotic simulated regimen achieved optimal CFR against <it>P. aeruginosa </it>and <it>A. baumannii</it>. Piperacillin/tazobactam dosed at 4.5 g q8h achieved the lowest CFR against all bacteria.</p> <p>Conclusions</p> <p>This study suggests that the carbapenems provide the greatest likelihood of clinical success for the <it>Enterobacteriaceae</it>, and combination therapy might be needed when choosing empirical therapy, especially when <it>A. baumannii </it>or <it>P. aeruginosa </it>are suspected.</p>