caa a22 4500 39759335X CHVBK 20180308164945.0 cr unu---uuuuu 161202e199607 xx s 000 0 eng 10.1093/jac/38.suppl_A.155 doi (NATIONALLICENCE)oxford-10.1093/jac/38.suppl_A.155 Grüneberg R. N. Department of Clinical Microbiology, University College Hospital, Grafton Way, London, UK The Alexander Project: using in-vitro susceptibility data for choosing empirical therapy in LRTI [Elektronische Daten] [R. N. Grüneberg] An international collaborative survey of susceptibility in community-acquired lower respiratory tract infection pathogens collected >6000 strains from six countries during 1992 and 1993. The four major pathogens were Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus. MICs of 15 antibiotics were determined and sensitivity interpretations applied using breakpoints based on those of the NCCLS. This analysis highlighted some anomalies, notably for β-lactams against S. pneumoniae and macrolides against H. influenzae where apparent sensitivity proportions did not accord with the distribution of MICs. Further analyses were undertaken in order to rank the antibiotics in order of potential usefulness for empirical treatment of LRTI: these included in-vitro potency (mode MIC and MIC90) and a pharmacodynamic comparison, using the ratio Cmax (free drug): MIC90. According to study breakpoints, the most active agents overall were, for S. pneumoniae, cefuroxime, clarithromycin, ofloxacin and chloramphenicol; for H. influenzae, azithromycin, amoxycillin/ clavulanate, cefixime, ceftriaxone, quinolones and doxycycline. However, other analyses suggested that the most active agents overall were, for S. pneumoniae, amoxycillin (±clavulanate) and ceftriaxone, and, for H. influenzae quinolones, ceftriaxone, cefixime and amoxycillin/clavulanate. Overall, the antimicrobial agents with the greatest potential usefulness for empirical treatment were amoxycillin/ clavulanate, ceftriaxone, cefuroxime, ofloxacin and co-trimoxazole. The choice of empirical therapy depends upon local epidemiology and clinician choice, but the Project data may be of value in the decision-making process. © 1996 The British Society for Antimicrobial Chemotherapy Articles nationallicence Journal of Antimicrobial Chemotherapy Oxford University Press 38(1996-07), 155-170 0305-7453 38<155 1996 38 jac https://doi.org/10.1093/jac/38.suppl_A.155 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jac/38.suppl_A.155 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Grüneberg R. N. Department of Clinical Microbiology, University College Hospital, Grafton Way, London, UK NATIONALLICENCE 773 0- Journal of Antimicrobial Chemotherapy Oxford University Press 38(1996-07), 155-170 0305-7453 38<155 1996 38 jac Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford