EUCAST breakpoints; susceptible ≤4, resistant ≥16
Currently there are no breakpoints for this antibiotic. However, moxifloxacin demonstrates in vitro activity against some Enterococcus species and a provisional breakpoint of susceptible ≤1 has been suggested (Andrews, et al. 1999). An infectious disease consult may be useful if you are considering using moxifloxacin for the treatment of Enterococcal infections.
A result of "R(comment)" or "Resistant (with comment)" indicates that an isolate has inducible clindamycin resistance. Clindamycin may still be used in combination regimes but should not be used alone to treat infections caused by bacteria with inducible resistance.
A result of "R(comment)" or "Resistant (with comment)" indicates that an isolate has inducible clindamycin resistance. Clindamycin may still be used in combination regimes but should not be used alone to treat infections caused by bacteria with inducible resistance.
In patients with streptococcal endocarditis, use American Heart Association (AHA) breakpoints for penicillin:
Susceptible ≤0.12µg/ml
Intermediate >0.12 to <0.5µg/ml
Resistant ≥0.5µg/ml
For further information, please see: Baddour, et al. 2015.
EUCAST breakpoint; susceptible ≤2, resistant ≥4
Currently there are no existing breakpoints for this antibiotic. However, a provisional susceptible breakpoint of ≤1 has been suggested for S. pneumoniae and could be considered applicable to viridans group streptococci (Andrews, et al. 1999).
A result of "R(comment)" or "Resistant (with comment)" indicates that an isolate has inducible clindamycin resistance. Clindamycin may still be used in combination regimes but should not be used alone to treat infections caused by bacteria with inducible resistance.
In the event that a patient is thought to have meningitis, but a CSF specimen has not been obtained, the “meningitis” interpretation should be used to guide therapeutic decisions.
A result of "R(comment)" or "Resistant (with comment)" indicates that an isolate has inducible clindamycin resistance. Clindamycin may still be used in combination regimes but should not be used alone to treat infections caused by bacteria with inducible resistance.
Per EUCAST: susceptibility can be inferred from the penicillin susceptibility result.
EUCAST breakpoints; susceptible ≤0.5, resistant ≥2
Current CLSI interpretive breakpoints may not predict clinical efficacy. Only strains with MIC ≤1.0 may be regarded as fully susceptible. Strains with MICs 2.0-4.0 should be considered to have dose-dependent susceptibility. A cefepime MIC = 8 has been associated with clinical failure. (Bhat, et al. 2007; Crandon, et al. 2010; Lee, et al. 2007; Paterson, et al. 2001).
CLSI interpretive breakpoints may not predict clinical efficacy. PK/PD analyses support the EUCAST recommendation that only strains with piperacillin-tazobactam MICs ≤ 8 be considered susceptible (DeRyke, et al. 2007).
For serious infections, CLSI interpretive breakpoints may not predict clinical efficacy. PK/PD analyses suggest that ciprofloxacin and levofloxacin MICs should be ≤0.125-0.25 and ≤0.25-0.5, respectively, for isolates to be considered susceptible (DeRyke, et al. 2007; Frei, et al. 2008).
No CLSI interpretive breakpoints are available. EUCAST interpretive breakpoints: susceptible ≤0.5, resistant ≥2
Current CLSI interpretive breakpoints may not predict clinical efficacy.Only strains with MIC ≤1.0 may be regarded as fully susceptible. Strains with MICs 2.0-4.0 should be considered to have dose-dependent susceptibility. A cefepime MIC = 8 has been associated with clinical failure. (Bhat, et al. 2007; Crandon, et al. 2010; Lee, et al. 2007; Paterson, et al. 2001).
For serious infections, CLSI interpretive breakpoints may not predict clinical efficacy. PK/PD analyses suggest that ciprofloxacin and levofloxacin MICs should be ≤0.125-0.25 and ≤0.25-0.5, respectively, for isolates to be considered susceptible (DeRyke, et al. 2007; Frei, et al. 2008). Many authorities recommend combination therapy for serious P. aeruginosa infections.
No CLSI interpretive breakpoints are available. The FDA interpretive breakpoint for Enterobacteriacae (susceptible ≤2) is unlikely to predict clinical efficacy. Tigecycline only achieves steady-state serum concentrations of 0.4-0.6, and PK/PD analyses suggest that MICs should be ≤0.25 to be considered susceptible. Treatment failures have been reported with tigecycline monotherapy for serious Acinetobacter infections (Pankey, et al. 2005; Ambrose, et al. 2009; Anthony, et al. 2008).
Current CLSI interpretive breakpoints may not predict clinical efficacy.Only strains with MIC ≤1.0 may be regarded as fully susceptible. Strains with MICs 2.0-4.0 should be considered to have dose-dependent susceptibility. A cefepime MIC = 8 has been associated with clinical failure. (Bhat, et al. 2007; Crandon, et al. 2010; Lee, et al. 2007; Paterson, et al. 2001).
For serious infections, CLSI interpretive breakpoints may not predict clinical efficacy. PK/PD analyses suggest that ciprofloxacin and levofloxacin MICs should be ≤0.125-0.25 and ≤0.25-0.5, respectively, for isolates to be considered susceptible (DeRyke, et al. 2007; Frei, et al. 2008).
PK/PD analyses suggest that only strains with piperacillin-tazobactam MICs ≤8 should be considered susceptible (DeRyke, et al. 2007).
No CLSI or EUCAST breakpoints are available. However, EUCAST breakpoints for Enterobacteriacae may be tentatively used for guidance: susceptible ≤0.5, resistant ≥2
Susceptibility is dependent on achieving the maximal possible blood level. ID consult recommended.
Flucytosine should be used in combination with another antifungal agent to prevent emergence of resistance (Drew, et al. 2013).
Current data are insufficient to demonstrate a correlation between in vitro susceptibility testing and clinical outcome for Candida glabrata (CLSI 2012)
EUCAST interpretive criteria for C. parapsiolosis and micafungin: susceptible ≤2, resistant >2. C. parapsilosis harbors an alteration in the echinocandin target gene and the MIC's of the echinocandins are higher than for other Candida species (EUCAST 2013). Multiple studies have shown C. parapsilosis to be intrinsically less susceptible to micafungin and breakthrough cases of C. parapsilosis invasive infection have been reported (Pfeiffer, et al. 2010).
Last updated 2024-05-31T20:05:52.991038+00:00