Clinical breakpoints and dosing of antibiotics

Clinical breakpoints - breakpoints and guidance

 

The 2022, v 12.0 breakpoint table for bacteria has several revised breakpoints, new species (Vibrio spp), disk diffusion methodology and criteria for anaerobic bacteria, disk diffusion criteria for meropenem-vaborbactam, recommendations for screening tests, more breakpoints in brackets, new layout for flow charts and revised guidelines for what to do when there are no breakpoints. Disk diffusion breakpoints for anaerobic bacteria are valid for FAA with 5% mechanically defibrinated horse blood as the only additive.

 

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 Older, no longer valid, breakpoint tables can be accessed through the archive.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.

 

Breakpoint tables

Make sure the device you are using for the presentation of tables can correctly display footnotes (Note1,Note2) and other typographical tools.