PDF(Pubmed)
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.
摘要：
传统上,头孢菌素敏感性结果用于预测其他头孢菌素的敏感性；然而，2013-2014年,临床和实验室标准研究所(CLSI)重新审视了这一做法,并确定头孢唑林对于无并发症的尿路感染(uUTIs)是比头孢菌素更准确的替代药物.因此,建立了一个头孢唑啉代孕断点来预测7种口服头孢菌素对大肠杆菌的敏感性，肺炎克雷伯菌,和在uUTI的背景下的变形杆菌。临床微生物学实验室在实施头孢唑啉代孕断点时面临几个操作挑战，这可能会导致对最佳前进道路的困惑。这里,我们回顾代孕断点背后的历史背景和数据，审查口服头孢菌素的PK/PD概况，讨论部署断点的挑战，并强调了该空间中有限的临床结果数据。
