Skip to main content

Table 6 Pathogen/antibiotic combinations that present major changes and potential therapeutic consequences

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

Pathogen/antibiotic CLSI CLSI CLSI EUCAST EUCAST EUCAST Major categorical shift Potential therapeutic consequences Possible alternative/s
%S % I % R %S % I % R
S. pneumoniae/          
Amoxicillin-clavulanate 95.6 4.3 0.1 73.4 13.9 12.7 S→I/R Reduced or no efficacy Increased dosage of amoxicillin-clavulanate
(2457) (110) (2) (1884) (358) (326)    
(2568)
Cefaclor 92.3 1.7 5.9 0.5 86.7 13 S→I/R Reduced or no efficacy Other oral cephalosporin/high dosage of amoxicillin-clavulanate
(2581) (2384) (45) (152) (13) (2238) (330)    
Ofloxacin 95.4 4.3 0.3 0.0 99.5 0.3 S→I Reduced efficacy Fluoroquinolones (moxifloxacin, levofloxacin, gemifloxacin)
(4412) (4208) (190) (14)   (4388) (14)    
H. influenzae/          
Cefaclor 92.6 5.2 2.3 3.5 / 96.5 S→R No efficacy Other cephalosporin/amoxicillin-clavulanate
(28338) (26337) (1481) (654) (990)   (27482)    
Cefuroxime-axetil 97.9 1.5 0.6 1.3 75.6 23.1 S→I/R Reduced or no efficacy Other cephalosporin/amoxicillin-clavulanate
(94671) (92668) (1390) (613) (1249) (71574) (21848)    
Cefuroxime- 97.9 1.5 0.6 76.9 10.5 12.6 S→ I/R Reduced or no efficacy Other cephalosporin/amoxicillin-clavulanate
parenteral (92668) (1390) (613) (72823) (9963) (11885)    
(94671)
Azithromycin 99.3 / / 1.2 98.1 0.7 S→I Reduced or no efficacy Betalactam/fluoroquinolones
(29942) (29733)    (350) (29383) (209)    
Clarithromycin 82.9 15.3 1.8 1.5 98.1 0.3 S→I Reduced or no efficacy Betalactam/fluoroquinolones
(27816) (23045) (4257) (514) (424) (27296) (96)    
Telithromycin 89.9 9.0 1.1 0.5 99.1 0.4 S→I Reduced or no efficacy Betalactam/fluoroquinolones
(5382) (4837) (486) (59) (26) (5335) (21)    
M. catarrhalis/          
Cefaclor 95.1 3.4 1.6 0.27 / 99.7 S→R No efficacy Other cephalosporin/amoxicillin-clavulanate
(7536) (7163) (253) (120) (21)   (7515)    
Cefuroxime-axetil 98.7 1.1 0.1 1.2 97.5 1.3 S→I/R Reduced or no efficacy Other cephalosporin/amoxicillin-clavulanate
(15381) (15183) (175) (23) (189) (14994) (198)    
  1. S. pneumoniae CLSI 2012 intermediate breakpoint (mg/L) amoxicillin-clavulanate 4/2, cefaclor 2, ofloxacin 4; EUCAST 2012 intermediate breakpoint (mg/L) amoxicillin-clavulanate 1–2, cefaclor 0.06-0.5, ofloxacin 0.25-4; CLSI 2012 resistance breakpoint (mg/L) amoxicillin-clavulanate ≥8/4, cefaclor ≥4, ofloxacin ≥8; EUCAST 2012 resistance breakpoint (mg/L) amoxicillin-clavulanate >2, cefaclor >0.5, ofloxacin >4.
  2. H. influenzae CLSI 2012 intermediate breakpoint (mg/L) cefaclor 16, cefuroxime axetil 8, cefuroxime parenteral 8, azithromycin ND, clarithromycin 16, telithromycin 4; EUCAST 2012 intermediate breakpoint (mg/L) cefaclor ND, cefuroxime axetil 0.25-1, cefuroxime parenteral 2, azithromycin 0.25-4, clarithromycin 2–32, telithromycin 0.25-8; CLSI 2012 resistance breakpoint (mg/L) cefaclor ≥32, cefuroxime axetil ≥16, cefuroxime parenteral ≥16, azithromycin ND, clarithromycin ≥32, telithromycin ≥8; EUCAST 2012 resistance breakpoint (mg/L) cefaclor >0.5, cefuroxime axetil >1, cefuroxime parenteral >2, azithromycin >4, clarithromycin >32, telithromycin >8.
  3. M. catarrhalis CLSI 2012 intermediate breakpoint (mg/L) cefaclor 16, cefuroxime axetil 8; EUCAST 2012 intermediate breakpoint (mg/L) cefaclor ND, cefuroxime axetil 0.25-4.
  4. CLSI 2012 resistance breakpoint (mg/L) cefaclor ≥32, cefuroxime axetil ≥16; EUCAST 2012 resistance breakpoint (mg/L) cefaclor >0.12, cefuroxime axetil >4.