Antimicrobial Susceptibility Testing Update - SWACM

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Why was cefepime breakpoint notlowered?♦ Monte Carlo simulation showed target attainment tosupport susceptible breakpoint at ≤8 g/ml• 2 g every 12 h = 91%• 1 g every 8 h = 100%(goal of 50% T > MIC attained for MIC = 8 g/ml)♦ 75% of US treatment courses are 3 to 4 g per day♦ Murine thigh model data supported breakpointsof ≤8, 16, ≥32g/mleven with high inoculum... but “controversial”♦ Some use EUCAST breakpoints (µg/ml)((≤1S,>44 R)♦ Some edit “S” to “R” if ESBL positive
CLSI M100-S19. 2009Group ATable 1“Drugs to Test/Report”EnterobacteriaceaeRevised… location of cephalothinCephalothinCLSI M100-S20. 2010Group U
Page 1 and 2: Antimicrobial SusceptibilityTesting
Page 3 and 4: CLSI AST StandardsAugust 2010M100-S
Page 5: Ceftriaxone Prescribing Information
Page 8 and 9: Enterobacteriaceae - Cephalosporins
Page 10 and 11: Table 2A Enterobacteriaceae♦ Dosi
Page 12 and 13: Why did CLSI lower cephalosporin,az
Page 14 and 15: Old ParadigmEmergence of a new β-l
Page 16 and 17: www.eucast.org
Page 18 and 19: MEROPENEM MIC distribution exampleB
Page 20 and 21: PK-PD PD Goal (“Target(Target”)
Page 22 and 23: Factors that Affect PK-PDPDTarget A
Page 24 and 25: What PK-PD PD data were used torevi
Page 26 and 27: Probability of Target AttainmentImi
Page 28 and 29: ImipenemProbability ofTarget Attain
Page 30 and 31: Enterobacteriaceae% Capture of Carb
Page 32 and 33: Meropenem MIC DistributionsEnteroba
Page 34 and 35: Expected Results forCarbapenemase-P
Page 36 and 37: Cumulative Ceftriaxone MIC Distribu
Page 38 and 39: Ceftriaxone MIC DistributionC. freu
Page 40 and 41: E. coli, Klebsiella spp., Proteus m
Page 42 and 43: Expected Results forESBL-ProducersC
Page 46 and 47: Why did cephalothin get moved?As re
Page 48 and 49: What narrow-spectrum cephalosporin
Page 50 and 51: Brief CLSI and FDABreakpoint (BP) S
Page 52 and 53: Steps to ImplementingNew CLSI Cepha
Page 54 and 55: Status of New Breakpoint Concentrat
Page 56 and 57: Some concerns about the newbreakpoi
Page 58 and 59: http://www.clsi.org/Content/Navigat

Antimicrobial Susceptibility Testing Update - SWACM

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