Susceptible, intermediate, and resistant - the intensity of antibiotic action

Dtsch Arztebl Int. 2008 Sep;105(39):657-62. doi: 10.3238/arztebl.2008.0657. Epub 2008 Sep 26.

Abstract

Introduction: To date, the resistance of infectious agents has been assessed by widely varying criteria in different countries. Therefore, published data on resistance often cannot be meaningfully compared. In Germany, different laboratories can potentially report different results for identical microorganisms, since there is no uniform system for categorization. This situation is unsatisfactory.

Methods: Selective literature review and evaluation of committee reports.

Results: The new ISO standard 20776 for determination of the resistance of infectious agents and the harmonized evaluation system of the European Society for Clinical Microbiology and Infectious Diseases provide a new basis for susceptibility testing. The categorization of infectious agents as "susceptible," "intermediate," or "resistant" to particular antibiotics will become more reliable and will be consistent throughout Europe.

Discussion: For a number of antibiotics, the criteria for evaluation of infectious agents as "susceptible," "intermediate", or "resistant" will change. Comparability with earlier resistance data will be compromised. However, the new evaluation criteria reflect current knowledge on the pharmacokinetics and pharmacodynamics of antimicrobial substances.

Keywords: antibiotic; bacteriological testing; in-vitro diagnostic agent; pharmakokinetics; resistance testing.