MICROBIOLOGY SUSCEPTIBLITY REPORTING

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Reporting of antibiotic susceptibility from microbiology laboratories is changing in line with EUCAST recommendations.   From June 2021, you will see more antibiotics reported as I as well as the more familiar S and R.   The definitions of these are listed below

S	Susceptible at standard dose
I	Susceptible, increased exposure (= increased dose)
R	Resistant even with increased exposure/dose

Agents reported as “I” are still appropriate treatment options when given at the correct (higher) dose.   These higher doses are listed in the table below.  

If in doubt or antibiotic dose not listed below please discuss with clinical microbiologist. 

Drug	Increased Dose
Benzylpenicillin	1.2g to 2.4g 4-6 hourly In S. pneumoniae, dose required is specified on reports
Temocillin IV	2g 8 hourly
Piperacillin/tazobactam IV	4.5g 6 hourly
Ceftazidime IV	2g 8 hourly
Aztreonam IV	2g 6 hourly
Co-trimoxazole IV/Oral	1440mg 12 hourly
Amoxicillin Oral	1g 8 hourly
Co-amoxiclav Oral	Co-amoxiclav 625mg 8 hourly + Amoxicillin 500mg 8 hourly
Levofloxacin IV/Oral	500mg 12 hourly
Ciprofloxacin IV	400mg 8 hourly
Ciprofloxacin Oral	750mg 12 hourly

Please note these doses are applicable to dosing in adults with normal renal and hepatic function.   In impaired hepatic/renal function please adjust accordingly/discuss with pharmacist.

For information on dose changes for children, please see the advice from Scottish Antimicrobial Prescribing Group, Paediatric Stewardship Working Group 

Aminoglycoside sensitivity reporting has changed in line with EUCAST recommendations.  This does not affect clinical practice, provided patients are improving on therapy.