ArticleThe Journal of antimicrobial chemotherapy2025
Results from the Survey of Antibiotic Resistance (SOAR) 2018-21 in Kuwait and the United Arab Emirates: 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 antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae from community-acquired respiratory tract infections in Kuwait and United Arab Emirates (UAE), collected in 2018-21.
methodsMICs determined by CLSI broth microdilution; susceptibility data interpreted using CLSI and EUCAST breakpoints.
resultsA total of 49 S. pneumoniae and 79 H. influenzae and 49 S. pneumoniae and 34 H. influenzae were collected from Kuwait and UAE, respectively. Of the pneumococci, 26.5% (UAE) and 20.4% (Kuwait) were penicillin susceptible by CLSI oral/EUCAST low-dose breakpoints; by CLSI intravenous/EUCAST high-dose administration, 95.9% (UAE) and 85.7% (Kuwait) were susceptible. Similar susceptibility was observed to ceftriaxone, amoxicillin/clavulanic acid, amoxicillin and cefotaxime (CLSI: 73.5%-93.9%) but lower to other cephalosporins, tetracyclines, macrolides and trimethoprim/sulfamethoxazole. Fluoroquinolones were ≥98.0% susceptible (CLSI/EUCAST high-dose). Compared with CLSI, activity was similar by EUCAST high-dose or pharmacokinetic/pharmacodynamic (PK/PD) breakpoints with few exceptions. Of the H. influenzae isolates, 17.7% (Kuwait) and 8.8% (UAE) carried β-lactamases. Significant differences in H. influenzae susceptibility (CLSI) were found for amoxicillin/clavulanic acid (81.0% Kuwait/97.1% UAE) and fluoroquinolones (UAE: levofloxacin 88.2%, moxifloxacin 82.4%; Kuwait: both 98.7%). Susceptibility was overall >91.2% (CLSI) except for ampicillin (81.0% Kuwait) and trimethoprim/sulfamethoxazole (47.1% UAE/55.7% Kuwait). EUCAST susceptibility was similar, except for cefuroxime. PK/PD susceptibility was similar to CLSI, but lower for cefaclor, cefuroxime and macrolides.
conclusionsPneumococci were susceptible to fluoroquinolones (>98%), amoxicillin and amoxicillin/clavulanic acid (>79%-94%), ceftriaxone and cefotaxime (>73%-94%). Susceptibility was lower to oral/low-dose penicillin (20%-27%), macrolides (33%-51%), tetracyclines (53%-59%) and trimethoprim/sulfamethoxazole (33%-61%). Susceptibility was generally >80% in H. influenzae except for trimethoprim/sulfamethoxazole (47%-56%).
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