Does the adoption of EUCAST susceptibility breakpoints affect the selection of antimicrobials to treat acute community-acquired respiratory tract infections?

Table 3 Antimicrobial susceptibility of H. influenzae as classified by CLSI and EUCAST §

Antimicrobial agent^a(n° of strains)	CLSI susceptibility breakpoint (mg/L)	EUCAST susceptibility breakpoint(mg/L)	CLSI %S	EUCAST %S	Type of discrepancy^b
Ampicillin-sulbactam (223)	≤2	≤1	98.2	92.4	minor
Amoxicillin-clavulanate (47.030)	≤4	≤2	99.7	98.4	minor
Cefaclor (28.338)	≤8	≤0.5	92.6	3.5	very major
Cefixime (7.403)	≤1	≤0.125	99.9	97.9	minor
Cefpodoxime (20.842)	≤2	≤0.25	99.9	96.7	minor
Cefuroxime axetil (94.671)	≤4	≤0.125	97.9	1.3	very major
Cefuroxime parenteral (94.671)	≤4	≤1	97.9	76.9	major
Cefotaxime (13.655)	≤2	≤0.125	99.6	99.7	-
Ceftriaxone (170)	≤2	≤0.125	100	96.5	minor
Cefepime (396)	≤2	≤0.25	100	91.7	minor
Ceftibuten (444)	≤2	≤1	98.4	97.1	minor
Meropenem non meningitis (6.511)	≤0.5	≤2	99.9	100	-
Imipenem (3.828)	≤4	≤2	98.9	97.4	minor
Ciprofloxacin (12.794)	≤1	≤0.5	99.7	99.6	-
Levofloxacin (22.880)	≤2	≤1	99.9	99.8	-
Moxifloxacin (14.177)	≤1	≤0.5	99.7	99.8	-
Ofloxacin (3.762)	≤2	≤0.5	100	99.9	-
Azithromycin (29.942)	≤4	≤0.125	99.3	1.2	very major
Clarithromycin (27.816)	≤8	≤1	82.9	1.5	very major
Telithromycin (5.382)	≤4	≤0.125	99.0	0.5	very major
Tetracycline (39.928)	≤2	≤1	97.7	96.8	-

§ CLSI [11] and EUCAST [13].
^aFor Ampicillin, Chloramphenicol, Ertapenem, Rifampin and Trimethoprim/sulfamethoxazole CLSI and EUCAST suggested the same susceptibility breakpoints.
^b Discrepancy as defined in the materials and methods section.

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