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University of Pennsylvania Medical Center Guidelines for Antimicrobial Therapy


Streptococcus pneumoniae

Combined Data for the Hospital of the University of Pennsylvania , Presbyterian Medical Center, and the UPHS Outpatient Practices - January 2012 to December 2012 (Using non-meningitis breakpoints)

%
 
Blood
Non-blood
  n S I R n S I R
Penicillin 24 100 0 0 93 88 3 8
Ceftriaxone 24 100 0 0 36 83 14 3
Levofloxacin 24 100 0 0 92 96 1 3
Erythromycin 24 96 0 4 92 79 1 20
Clindamycin* 24 96 0 4 92 79 1 20
Cotrimoxazole (Sulfa-TMP) 24 92 0 8 92 84 1 15
Vancomycin 9 100 0 0 33 100 0 0
*erythromycin-resistant isolates were tested for induction of clindamycin resistance - no induced resistance was detected

 

2011 CLSI Breakpoints for S. pneumoniae
 
S
I
R
Penicillin G-pneumonia <=2 4 >=8
Penicillin G- meningitis & PenVK for pneumonia <=0.06 0.12-1 >=2
Levofloxacin <=2 4 >=8
Ceftriaxone <=1 2 >=4
Erythromycin <=0.25 0.5 >=1
Clindamycin <=0.25 0.5 >=1
Cotrimoxazole <=0.5/9.5 1/19.-2/38 >=4/76
Vancomycin <=1    

 

Isolates that are susceptible to penicillin can be considered susceptible to ampicillin, amoxicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefepime, cefotaxime, ceftriaxone, and imipenem for approved indications. Note that the CLSI changed the penicillin G breakpoints for pneumococcal pneumonia in 2008, which had the effect of placing many more isolates in the "S" category. There remain different breakpoints for pneumococcal meningitis, and there is a new category for the treatment of pneumococcal pneumonia with PenVK.

 

Penicillin MICs Pneumococci 2011

 


 

 

View Inpatient Susceptibility Results

Archived pneumococcal susceptibility data January 2001-Dec2006

Archived pneumococcal susceptibility data 2007

Archived pneumococcal susceptibility data 2008

Archived pneumococcal susceptibility data 2010-2011

updated 4/10/13 P. Edelstein