ArticleThe Journal of antimicrobial chemotherapy2025
Results from the Survey of Antibiotic Resistance (SOAR) 2018-21 in Türkiye: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.
Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo determine the antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae from community-acquired respiratory tract infections from four hospitals in Türkiye in 2018-21.
methodsMICs were determined by CLSI methodology, and susceptibility was interpreted using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.
resultsS. pneumoniae (n = 142) and H. influenzae (n = 315) isolates were collected. Penicillin susceptibility in pneumococci was 35.9% by CLSI oral/EUCAST low-dose breakpoints and 82.4% by EUCAST high-dose/CLSI intravenous administration. Similar susceptibility (78.2%-82.4%, CLSI) was observed for ceftriaxone, amoxicillin/clavulanic acid, amoxicillin and cefotaxime. Other cephalosporins, tetracyclines, macrolides and trimethoprim/sulfamethoxazole were poorly active (42.3%-59.2%); fluoroquinolones (≥97.9%) were most active. Susceptibility by EUCAST was lower for high-dose amoxicillin (64.8%), high-dose amoxicillin/clavulanic acid (59.2%) and cefaclor (0%), but higher for high-dose ceftriaxone (99.3%). High-dose PK/PD breakpoints for amoxicillin and amoxicillin/clavulanic acid increased susceptibility (87.3% and 88.0%). Most H. influenzae were β-lactamase negative (n = 294, 93.3%); 26 (8.3%) were β-lactamase-negative ampicillin-resistant by EUCAST breakpoints and eight (2.5%) by CLSI breakpoints. Antibiotic susceptibility was ≥91.8% (CLSI) except ampicillin (85.4%) and trimethoprim/sulfamethoxazole (64.1%). EUCAST or PK/PD breakpoint susceptibility was similar, except for oral cefuroxime (0% EUCAST, 71.7% PK/PD and 99.4% CLSI) and macrolides (no EUCAST breakpoint, 1.0%-2.5% PK/PD and 96.5%-99.1% CLSI).
conclusionsSusceptibility in S. pneumoniae was <60% except for fluoroquinolones, amoxicillin and amoxicillin/clavulanic acid, cefotaxime and ceftriaxone. H. influenzae susceptibility to most antibiotics was >90% except for trimethoprim/sulfamethoxazole and ampicillin. These data are similar to recent surveillance of antibiotic resistance data in Türkiye.
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