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MIC Discrepancies between Parenteral and Oral Anti-Staphylococcal Beta-Lactams among MSSA.
Hernandez, Brandy N; Dilworth, Thomas; Kesner, Jacob; Ryan, Keenan; Thelen, Haedi; Mercier, Renée-Claude.
Afiliación
  • Hernandez BN; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, New Mexico, USA.
  • Dilworth T; Department of Pharmacy, Advocate Aurora Health Milwaukee, Milwaukee, Wisconsin, USA.
  • Kesner J; Department of Pharmacy, Lovelace Medical Center, Albuquerque, New Mexico, USA.
  • Ryan K; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, New Mexico, USA.
  • Thelen H; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, New Mexico, USA.
  • Mercier RC; Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, New Mexico, USA.
Chemotherapy ; 68(1): 55-60, 2023.
Article en En | MEDLINE | ID: mdl-36001946
INTRODUCTION: Recent evidence has shown that oral antibiotic therapy is not inferior to IV antibiotic therapy in the treatment of complicated Staphylococcus aureus infections. Therefore, oral antibiotic therapy is now frequently prescribed in clinical practice due to cost benefit, ease of administration, decreased complication rate, and lack of need for IV access. In vitro susceptibility testing for ß-lactam oral antibiotics is not routinely performed as the guidelines provided by the Clinical and Laboratory Standards Institute (CLSI) recommend using oxacillin and cefoxitin as surrogate markers. Hence, oral antibiotic susceptibilities for cephalexin and dicloxacillin are not reported and implied based on oxacillin and cefoxitin. The objective of the current study was to determine whether susceptibilities among S. aureus isolates are predictable when comparing commonly used IV and oral beta-lactams. METHODS: Cefazolin, cephalexin, dicloxacillin, and oxacillin broth microdilution minimum inhibitory concentrations (MICs) were determined for 100 clinical isolates of methicillin-sensitive S. aureus by broth microdilution following CLSI guidelines. RESULTS: Among these isolates, median MICs for cephalexin were eight-fold higher than cefazolin MICs and median MICs for dicloxacillin were four-fold less than oxacillin MICs. Ten percent of more strains studied had a major or very major error in its susceptibility reporting when cephalexin was compared to its surrogate marker oxacillin. DISCUSSIONS/CONCLUSIONS: The variations in MICs observed compounded with the dosing and pharmacokinetic differences of oral versus IV ß-lactam suggests that establishing breakpoints for oral ß-lactam antibiotics is necessary to ensure adequate therapy is selected for the treatment of complex S. aureus infections.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Staphylococcus aureus Resistente a Meticilina Tipo de estudio: Guideline / Qualitative_research Límite: Humans Idioma: En Revista: Chemotherapy Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Staphylococcus aureus Resistente a Meticilina Tipo de estudio: Guideline / Qualitative_research Límite: Humans Idioma: En Revista: Chemotherapy Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza