Cefazolin as a predictor of urinary cephalosporin activity in indicated Enterobacterales.
| Autor: | Bryson AL; Department of Pathology, Virginia Commonwealth University Health System, Richmond, Virginia, USA., Bhalodi A; Scientific and Medical Affairs Consulting, Newton, Pennsylvania, USA., Liesman RM; Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Mathers AJ; Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health, Charlottesville, Virginia, USA.; Clinical Microbiology Laboratory, Department of Pathology, University of Virginia Health, Charlottesville, Virginia, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of clinical microbiology [J Clin Microbiol] 2024 Apr 10; Vol. 62 (4), pp. e0078821. Date of Electronic Publication: 2024 Mar 08. |
| DOI: | 10.1128/jcm.00788-21 |
| Abstrakt: | Traditionally, cephalothin susceptibility results were used to predict the susceptibility of additional cephalosporins; however, in 2013-2014, the Clinical and Laboratory Standards Institute (CLSI) revisited this practice and determined that cefazolin is a more accurate proxy than cephalothin for uncomplicated urinary tract infections (uUTIs). Therefore, a cefazolin surrogacy breakpoint was established to predict the susceptibility of seven oral cephalosporins for Escherichia coli , Klebsiella pneumoniae , and Proteus mirabilis in the context of uUTIs. Clinical microbiology laboratories face several operational challenges when implementing the cefazolin surrogacy breakpoint, which may lead to confusion for the best path forward. Here, we review the historical context and data behind the surrogacy breakpoints, review PK/PD profiles for oral cephalosporins, discuss challenges in deploying the breakpoint, and highlight the limited clinical outcome data in this space. Competing Interests: The authors declare no conflict of interest. |
| Databáze: | MEDLINE |
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