One Size Fits All? Application of Susceptible-Dose-Dependent Breakpoints to Pediatric Patients and Laboratory Reporting

J Clin Microbiol. 2019 Dec 23;58(1):e01446-19. doi: 10.1128/JCM.01446-19. Print 2019 Dec 23.

Abstract

The Clinical and Laboratory Standards Institute antimicrobial and antifungal standards define a susceptible-dose-dependent (SDD) category for certain organisms and drug combinations. Reporting MICs within the SDD category suggests that treatment success is likely with increased drug exposure. These breakpoints are based on pharmacokinetic, pharmacodynamic, and clinical outcome data from adults and not pediatric patients. This commentary aims to discuss the implications of reporting SDD interpretations for pediatric patients and recommends laboratory reporting comments.

Keywords: CLSI; M100; M40; MIC; antimicrobial agents; breakpoints; pediatric drug therapy; susceptible-dose dependent.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Infective Agents / pharmacology*
  • Anti-Infective Agents / therapeutic use
  • Antifungal Agents / pharmacology
  • Child
  • Clinical Laboratory Techniques / methods
  • Clinical Laboratory Techniques / standards
  • Humans
  • Microbial Sensitivity Tests / methods
  • Microbial Sensitivity Tests / standards*
  • Pediatrics* / methods

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Antifungal Agents