Clinical breakpoints - breakpoints and guidance
- Clinical breakpoints (v 13.1) - new file for printing (29 June, 2023) to make new breakpoints for anaerobic bacteria available (there are no changes beyond the tab for anaerobic bacteria)
- Clinical breakpoints (v 13.1) - new file for screen (29 June, 2023) to make new breakpoints for anaerobic bacteria available (there are no changes beyond the tab for anaerobic bacteria)
- Clinical breakpoints (v 13.0) - file for printing (2 Jan, 2023 - 29 June, 2023)
- Clinical breakpoints (v 13.0) - file for screen (2 Jan, 2023 - 29 June, 2023)
Major changes between breakpoint tables v 12.0 and 13.0 are: breakpoints and methods for Corynebacterium diphtheriae and C. ulcerans* added, several I categories removed (macrolides, tetracyclines, rifampicin), aminopenicillin breakpoints for Enterobacterales revised (flow chart soon to be published), additional breakpoints and dosages in meningitis, and several minor technical changes and clarifications. For a complete list of changes, see breakpoint table, tab "Changes". The revision of aminopenicillin breakpoints in Enterobacterales has been addressed in a guidance document (14 Jan, 2023).
*EUCAST has received queries on difficulties encountered with some databases when trying to distinguish between on one hand C. ulcerans and on the other C. pseudotuberculosis and C. silvaticum. Both species are uncommon in humans and have lower clindamycin MIC values than C. ulcerans. Neither has been considered or validated when EUCAST breakpoints were determined. Check the clinical relevance of the finding and if consider checking with a reference laboratory. - Clinical breakpoints - fungi
- Dosages (v 13.0) - file for printing and screen (2 Jan, 2023)
Before using the EUCAST breakpoint tables..... there are changes in the breakpoint tables every year. Some may be difficult to understand or accept without having followed the development of and consultations on "breakpoints-in-brackets, breakpoints "for screen only" amd the changing definitions of the susceptibility categories, especially the change from the old "intermediate" (I) to the new "Susceptible, increased exposure" (I). Users of the tables are urged to inform themselves on definitions of S, I and R, the use of the arbitrary, off-scale breakpoints and the fact that Pseudomonas aeruginosa, for many agents, is never reported S, only I, but is still possible to treat provided the dosing and mode of administration is considered. Visit the section on new definitions of S, I and R, the recorded webinar on how to handle the "Susceptible, increased exposure category" and read the first few tabs in the breakpoint table (Notes, Guidance, Dosage, Technical uncertainty). Also, backtrack through "consultations" to better understand how these were developed. For questions and comments on breakpoints, use the EUCAST subject related contact form.
Make sure the device you are using for the presentation of tables can correctly display footnotes (Note1,Note2) and other typographical tools.
- 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 Clinical breakpoint table. Older, no longer valid, breakpoint tables can be accessed through the archive.
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Definitions of clinical breakpoints and epidemiological cut off values
Modified definitions valid from 1 January, 2019.