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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 2014 to December 2014 (Using non-meningitis breakpoints)

%
 
Blood
Non-blood
  n S I R n S I R
Penicillin 16 100 0 0 87 87 7 6
Ceftriaxone 16 100 0 0 44 79 21 0
Levofloxacin 16 100 0 0 87 98 0 2
Erythromycin 16 56 0 44 87 61 1 38
Clindamycin* 16 81 0 19 87 80 1 19
Cotrimoxazole (Sulfa-TMP) 16 81 6 13 87 74 6 20
Vancomycin 9 100 0 0 54 100 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

Archived pneumococcal susceptibility data 2012

updated 12/8/14 P. Edelstein