TABLE 3.
Comparison of the susceptibility data from the EUCAST MIC distribution (MIC50 and MIC90) with the PK/PD breakpoints for the f TMIC targets of 40% and 75% for standard and optimized dosing regimens at 1 g ertapenem per dayc
| MIC90 coverage and pathogen (no. of isolates in EUCAST database) | EUCASTa |
fTMIC target of 40% (1 g as a 15-min infusion q24h) |
f TMIC target of 75% |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 g as a 15-min infusion q24h |
0.5 g as a 15-min infusion q12h |
1 g as a continuous infusion |
||||||||||||
| MIC50 (mg/liter) | MIC90 (mg/liter) | Plasma (1 mg/liter)b | SC (0.25 mg/liter) | PF (0.5 mg/liter) | Plasma (0.125 mg/liter) | SC (0.0625 mg/liter) | PF (0.125 mg/liter) | Plasma (1 mg/liter) | SC (0.5 mg/liter) | PF (1 mg/liter) | Plasma (2 mg/liter) | SC (0.5 mg/liter) | PF (1 mg/liter) | |
| MIC90 is covered for all regimens and sites | ||||||||||||||
| Proteus mirabilis (n = 1,426) | 0.008 | 0.016 | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ |
| Escherichia coli (n = 2,187) | 0.008 | 0.031 | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ |
| Klebsiella spp. (n = 342) | 0.016 | 0.031 | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ |
| Streptococcus pyogenes (n = 818) | 0.016 | 0.031 | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ |
| Klebsiella pneumoniae (n = 1,482) | 0.016 | 0.063 | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ |
| MIC90 is better covered by optimized regimens | ||||||||||||||
| Proteus vulgaris (n = 317) | 0.016 | 0.125 | +++ | +++ | +++ | +++ | + | +++ | +++ | +++ | +++ | +++ | +++ | +++ |
| Streptococcus viridans group (n = 335) | 0.063 | 0.25 | +++ | +++ | +++ | + | + | + | +++ | +++ | +++ | +++ | +++ | +++ |
| Enterobacter cloacae (n = 1,185) | 0.063 | 1 | +++ | + | + | + | + | + | +++ | + | +++ | +++ | + | +++ |
| Enterobacter spp. (n = 255) | 0.063 | 1 | +++ | + | + | + | + | + | +++ | + | +++ | +++ | + | +++ |
| Staphylococcus aureus (n = 1,071) | 0.125 | 1 | +++ | + | + | + | NC | + | +++ | + | +++ | +++ | + | +++ |
| MIC90 is not covered reliably by any regimen | ||||||||||||||
| Bacteroides fragilis (n = 296) | 0.25 | 2 | + | + | + | NC | NC | NC | + | + | + | +++ | + | + |
| Bacteroides fragilis group (n = 147) | 0.5 | 4 | + | NC | + | NC | NC | NC | + | + | + | + | + | + |
| Staphylococcus epidermidis (n = 203) | 1 | 128 | + | NC | NC | NC | NC | NC | + | NC | + | + | NC | + |
| Acinetobacter baumannii (n = 719) | 4 | 16 | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC |
| Enterococcus faecalis (n = 1,183) | 8 | 512 | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC |
| Enterococcus faecium (n = 325) | 256 | 256 | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC | NC |
a
As of 5 September 2016.
b
Numbers in parentheses are the PK/PD breakpoints for the respective dosing regimen and site.
c
q24h, every 24 h; SC, subcutaneous tissue; PF, peritoneal fluid; +++, the MIC90 is covered; +, the MIC50 is covered; NC, not covered.