Please use this identifier to cite or link to this item: https://scholarhub.balamand.edu.lb/handle/uob/2499
Title: Results from the Survey of Antibiotic Resistance (SOAR) 2015-17 in the Middle East (Kuwait, Lebanon and Saudi Arabia) : data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints
Authors: Torumkuney, D.
Mokaddas, E
Jiman-Fatani, A
Ageel, A
Daoud, Ziad
Bouferraa, Y
Zerdan, M B.
Morrissey, I.
Affiliations: Faculty of Medicine 
Keywords: Amoxicillin
Ampicillin
Ceftriaxone
Erythromycin
Antibiotic resistance
cefuroxime
Clarithromycin
amoxicillin-potassium clavulanate combination
cefaclor
Trimethoprim-sulfamethoxazole combination
levofloxacin
pharmacodynamics
Antimicrobial susceptibility
cefpodoxime
multi-antibiotic resistance
Subjects: Antibiotics
Kuwait
Lebanon
Saudi Arabia
Issue Date: 2020
Part of: Journal of antimicrobial chemotherapy
Volume: 75
Issue: S1
Start page: i60
End page: i75
Abstract: 
Objectives To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2015–17 from Kuwait, Lebanon and Saudi Arabia. Methods MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results A total of 139 S. pneumoniae isolates were collected from four centres in Kuwait, Lebanon and Saudi Arabia in 2015–17 and 55 H. influenzae isolates were collected and analysed from Saudi Arabia over the same time period. Pneumococci from all three countries were commonly non-susceptible to penicillin based on CLSI oral or low-dose IV penicillin using EUCAST breakpoints (39% in Kuwait to 57.1% in Lebanon) but by CLSI IV and EUCAST high-dose breakpoints most isolates were susceptible (∼90% in Kuwait and Saudi Arabia, and 100% in Lebanon). Isolates from Lebanon were highly susceptible to most other antibiotics (>90%) except cefaclor, oral cefuroxime and cefpodoxime (EUCAST breakpoints only). Overall, susceptibility was significantly lower in Kuwait and Saudi Arabia than Lebanon. Although all H. influenzae isolates (Saudi Arabia only) were β-lactamase negative, 3.6% and 12.7% were ampicillin resistant by CLSI and EUCAST breakpoints, respectively. Otherwise susceptibility was high in H. influenzae. The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. Conclusions Relatively low antibiotic susceptibility was observed in S. pneumoniae from Kuwait and Saudi Arabia in contrast to Lebanon, where rates of susceptibility were generally higher. Isolates of H. influenzae from Saudi Arabia were susceptible to most antibiotics. These factors are important in decision making for empirical therapy of CA-RTIs.
URI: https://scholarhub.balamand.edu.lb/handle/uob/2499
DOI: 10.1093/jac/dkaa084
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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