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With EUCAST guidelines being freely available it should be considered as an alternative especially in resource poor settings in order to maintain up-to-date antibiotic susceptibility interpretation. The previous method generated results against all E.

Accessed 22 Dec Secondly, details on the decision making process are not accessible to the public. Clinical and Laboratory Standards Institute. MIC result variations and summary of essential agreement rates between previously established broth microdilution method and revised reference method for telavancin.

Accessed 31 E23 Competing interests The authors declare that they have no competing interests. cksi

Antibiotics analyzed included amikacin, ceftazidime, ciprofloxacin, cefepime, gentamicin, meropenem and piperacillin—tazobactum. Four hundred sixty-two Gram-positive isolates, including a challenge set of organisms with reduced susceptibilities to comparator agents, were selected and tested using the revised method for telavancin, and the MIC results were compared with those tested by the previously established method and several Sensititre dry-form BMD panel formulations.

We reviewed minimum inhibitory concentrations MIC of various antibiotics routinely reported for Escherichia coli E. Of the E. These changes were motivated by an increased risk of treatment failure in patients with decreased ciprofloxacin susceptible Salmonella spp [ 15 ].

During the development of dalbavancin, also a lipoglycopeptide, the use of polysorbate 80 P 0. Differences in MIC results between frozen-form BMD methods were less significant for the streptococci, where the majority of MIC values obtained by the previous method were only 1 doubling dilution step higher than those obtained by the revised method Table 1.

Does the adoption of EUCAST susceptibility breakpoints affect the selection of antimicrobials to treat acute community-acquired respiratory tract infections? The kappa statistics for E. Telavancin MIC values obtained by the revised method were considered reference results for these analyses.

MIC result variations and summary of essential agreement rates between dry-form broth microdilution formulation panel Sensititre and revised reference method for telavancin. These results suggest that i P is necessary for a more accurate MIC determination for telavancin and previous studies underestimated the drug’s in vitro potency due to drug loss because of binding to plastic surfaces 1213— 15 and ii similar to dalbavancin and oritavancin, presence of LHB provides an effect similar to that of P Subsequent investigations for oritavancin another lipoglycopeptide demonstrated that the addition of P to MIC testing broth was also necessary for test performance reliability via minimizing the drug binding to plastic well panels 5similar to dalbavancin.


FarrellRodrigo E. Support Center Support Center. MendesPaul R.

Analysis year by year did not show any difference in the trends and overall susceptibilities. As for EUCAST, the industry only plays a consultative role and is not allowed to finance or participate in decision making [ 3 ].

The major discrepancy was in the intermediate and susceptible categories as 8. The revised method and subsequent differences in MIC results prompted the reestablishment of QC ranges for telavancin 9 and interpretive breakpoints 3. The revised BMD method provides lower MIC results for telavancin, especially when tested against staphylococci and enterococci. A total of clinical isolates were included in this study.

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In vitro susceptibility testing of fluoroquinolone activity against Salmonella: These breakpoints affect clinical decision making by determining whether an antibiotic is reported as susceptible or not. The difference between the two susceptibility cut-offs is two dilutions and this may require further harmonization.

In summary, these study results demonstrate that the previous BMD method adopted by CLSI use of DMSO as a cllsi and diluent for panel preparation and addition of P to the broth ensures a proper assessment of the telavancin MIC determination, especially when tested clxi staphylococci and enterococci. These antimicrobial profile characteristics have been very well documented in studies performed during drug development or after regulatory approval when applying the previous BMD method 1213— Similar experiments were performed for telavancin, m010 similar results were obtained data on file; Theravance, Inc.

Telavancin is a lipoglycopeptide antibiotic with potent in vitro bactericidal activity when tested against Gram-positive bacteria, including methicillin-susceptible Staphylococcus aureus MSSAmethicillin-resistant S.

Open in a clis window. Contributor Information Ali Kassim, Email: In effect this has led to a slightly higher meropenem resistance of For additional information, visit the CLSI website at www.


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Therefore, the reclassification of isolates that are intermediate by CLSI to susceptible by EUCAST is unlikely to contribute to adverse outcomes for patients with urinary tract infections. All authors read and approved the final manuscript. The determination of accurate antibiotic susceptibility is therefore an important cog in the clinical care of bacterial m1000 especially in organisms that possess acquired resistance mechanisms and careful consideration should be given when deciding how to interpret phenotypic susceptibility data [ 11 ].

As previously observed with dalbavancin 4 and oritavancin 5the data presented here, using a large collection of clinically relevant strains, shows that the revised BMD method containing the addition of P common to all clsu lipoglycopeptides provides lower MIC results than those obtained by the previous method, especially when tested against staphylococci and enterococci.

Published online Apr Lastly, the telavancin in vitro MIC results tested against Gram-positive organisms by the revised BMD method are now comparable to those reported k100 other lipoglycopeptide agents i.

Support Center Support Center. Advancing excellence in laboratory medicine for better healthcare worldwide. In addition, the telavancin MIC results obtained with the revised method were compared with several candidate dry-form formulation panels.

The revised method provided MIC results 2- to 8-fold lower than the previous method when tested against staphylococci and enterococci, resulting in MIC 50 values of 0.

Further investigations proposed the use of dimethyl sulfoxide DMSO as the solvent for stock solution preparation, as well as a stock solution diluent for panel preparation. Initial studies using this revised method observed that the MIC 50 results for telavancin were 4- to 8-fold lower than those obtained by the previous applied method use of DMSO and water as solvent and diluent for panel preparation, respectively, and no P supplementation when tested against staphylococci and enterococci, but minimal differences were observed when testing streptococci data on file; JMI Laboratories.