Assumed versus Approved Breakpoints

Preston, David A.; Turnak, M.R.

doi:10.1128/aac.44.11.3243-3245.2000

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…47 Although the NCCLS breakpoints for S. pneumoniae for certain antimicrobials have been modified and are now in line with PK/PD breakpoints, NCCLS breakpoints provide no interpretative criteria for M. catarrhalis, and substantial discrepancies remain between the NCCLS and PK/PD breakpoints for H. influenzae (Table 2). 48,49 Identifying mechanisms of resistance…”

Section: Towards a Better Understanding Of Resistancementioning

confidence: 99%

The Alexander Project: the benefits from a decade of surveillance

Felmingham¹,

White²,

Jacobs³

et al. 2005

Journal of Antimicrobial Chemotherapy

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The Alexander Project, initiated in 1992 as an international, multicentre, longitudinal surveillance study of antimicrobial susceptibility among common respiratory pathogens, has been pivotal in defining the role of global surveillance. At the time, there were few studies in which data were collected in a way that allowed meaningful comparisons to be made between studies, locations or over time. The project instituted the use of a central laboratory and standardized methods for the collection of isolates and determination of susceptibility, and this was continued with the addition of two further reference laboratories. Data from the study have provided a resource for measuring trends in the susceptibility patterns of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis at country, regional and global levels. Determination and publication of quantitative MICs enabled detailed assessment of changes in susceptibility distributions and assessment of microbiological and potential clinical susceptibility using different breakpoints, including those based on pharmacokinetic/pharmacodynamic parameters. Comparisons of antimicrobial usage patterns and resistance prevalences over time allowed hypotheses to be examined with respect to the role of quantity and type of antimicrobial use in the selection and spread of resistance. The resulting collection of isolates has provided a valuable resource for molecular studies into the evolution of resistance over time and location; a substantial proportion of this collection is now in the public domain. This paper reviews the 10 years of the Alexander Project and the benefits it has brought to an understanding of the evolution of antibacterial resistance in community respiratory bacteria.

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Section: Towards a Better Understanding Of Resistancementioning

confidence: 99%

The Alexander Project: the benefits from a decade of surveillance

Felmingham¹,

White²,

Jacobs³

et al. 2005

Journal of Antimicrobial Chemotherapy

View full text Add to dashboard Cite

show abstract

“…PK/PD breakpoints were based on standard dosing regimens and criteria appropriate to each agent for respiratory tract infections. 13,[19][20][21][22][23][24][25][26] For b-lactams, erythromycin and clarithromycin, these breakpoints were based on free drug concentrations in serum present for 40-50% of the dosing interval, while for azithromycin, the fluoroquinolones, and doxycycline, they were based on 24-hour unbound serum AUC/MIC ratio of 25 to 30 (Tables 1 and 2). Based on these criteria, a susceptible breakpoint of 4/2 mg/mL was used to represent the pharmacokinetically enhanced formulation of amoxicillin/clavulanic acid for all species tested.…”

Section: Discussionmentioning

confidence: 99%

“…BP = Breakpoint; NA = not applicable; -= no breakpoint available or not tested; S = susceptible; I = intermediate.a Breakpoints used to interpret MICs in this study, based on NCCLS and PK/PD breakpoints 13,[19][20][21][22][23][24][25][26]. .…”

mentioning

confidence: 99%