Clinical breakpoints and dosing of antibiotics

08 January 2019

Clinical breakpoints for bacteria

List of errors: (1) in the S.pneumoniae tab, "oxacillin 1 unit" shall of course read "oxacillin 1 microgram". (2) for ciprofloxacin and ofloxacin in the dosing tab, a comment reads "+combination" - this is a mistake and will be deleted in the next version of the table and dosing table.

In the 2019 breakpoint table we highlight the following new/changed items:

  • New breakpoints for meropenem-vaborbactam and eravacycline.
  • Several updates due to taxonomy changes.
  • Information added on EUCAST new definitions of the S, I and R categories.
  • Several breakpoint changes due to the new definition of the I category. See also the Guidance on tigecycline dosing and administration.
  • Trimethoprim breakpoints were removed for Enterococcus. The clinical efficacy is not predictable by AST. Using the ECOFF (now listed in a note in the table), it is however possible to predict the presence and absence of resistance mechanisms.
  • Areas of Technical Uncertainties (ATUs) and information on how to handle technical uncertainty in antimicrobial susceptibility testing added.
  • Flow charts for screening for beta-lactam resistance in S. pneumoniae and H. influenzae updated.
  • Several updates in the dosing tab.
  • Doripenem breakpoints in the 2018 vs. 8.1 table were removed from the 2019 v 9.0 table following a general consultation.It turned out that dporipenem is still available in some parts of the world. Refer to the v 8.1 table for breakpoints.

EUCAST instruction video on how to use the breakpoint table - download here

 

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Breakpoints published in Addendum during the year will be part of the next version of the full Clinical breakpoint tables valid from early January each year.

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Note: To correctly utilize functions in the Excel® breakpoint tables, use Microsoft™ original programs only.

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Breakpoints published in Addendum during the year will be part of the next version of the full Clinical breakpoint tables valid from early January each year.

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Previous versions of breakpoint tables

 

Previous versions of breakpoint tables. 

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Definitions of clinical breakpoints and epidemiological cut off values

Modified definitions valid from 1 January, 2019.