Cefazolin as a predictor of urinary cephalosporin activity in indicated Enterobacterales.
J Clin Microbiol
; 62(4): e0078821, 2024 Apr 10.
Article
en En
| MEDLINE
| ID: mdl-38457194
ABSTRACT
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.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infecciones Urinarias
/
Cefazolina
Límite:
Humans
Idioma:
En
Revista:
J Clin Microbiol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos