Reanalysis of cefazolin surrogate susceptibility breakpoints utilized as guidances for oral cephalosporin treatments of uncomplicated urinary tract infections: caution concerning application to cefadroxil

Diagn Microbiol Infect Dis. 2020 Jul;97(3):115053. doi: 10.1016/j.diagmicrobio.2020.115053. Epub 2020 Apr 1.

Abstract

Based on antimicrobial susceptibility test interpretive breakpoint criteria from Clinical and Laboratory Standards Institute and United States Committee on Antimicrobial Susceptibility Testing, cefazolin uncomplicated urinary tract infection (uUTI) surrogate breakpoints do not accurately predict cefadroxil or cephradine susceptibility when testing indicated Enterobacteriaceae species isolates. Hence, these two orally-administered cephalosporins (OC) are not equivalent spectrum substitutes for cephalexin or six other related OC agents for contemporary uUTI therapy.

Keywords: Cefadroxil; Cefazolin; False-susceptibility; Surrogate.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Cefadroxil / pharmacology
  • Cefadroxil / therapeutic use*
  • Cefazolin / pharmacology
  • Cefazolin / therapeutic use*
  • Cephalosporins / pharmacology
  • Cephalosporins / therapeutic use
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / isolation & purification
  • Humans
  • Microbial Sensitivity Tests / standards*
  • Practice Guidelines as Topic
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Cefadroxil
  • Cefazolin