Antibiograms: New NCCLS Guidelines, Development, and Clinical Application

Abstract

Antibiograms are an important resource for health care providers. All clinicians involved in antibiotic selection and monitoring should become familiar with the NCCLS M39-A document “Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data: Approved Guideline.” Providers who interpret and apply antibiogram data in clinical practice should know about susceptibility testing methods, the susceptibility breakpoint determination process, and problems associated with antibiogram data analysis. The M39-A guidelines contain more than 40 recommendations, including the following: antibiogram data should be analyzed at least annually, an attempt should be made to remove duplicate isolates, and only organisms with 10 isolates or more should be presented. Accurate antibiograms facilitate improved empiric antibiotic selection and more precise monitoring of bacterial resistance in the hospital. This article reviews common antimicrobial susceptibility testing methods and relevant issues, highlights the major NCCLS M39-A recommendations, discusses the antibiogram preparation process and challenges in data interpretation, and provides a general overview of how antibiogram data may be applied to clinical practice.

Effective Control of an Outbreak of Sepsis After Prostate Biopsy Using Antibiogram-Guided Antimicrobial Prophylaxis

“…21 Hospital antibiograms are widely available and are intended to provide clinicians with meaningful data to support the selection of agents guiding empiric antimicrobial therapy; monitor antimicrobial resistance trends within or across institutions at a given point in time; and determine whether a particular agent should be included within the institutional drug formulary. 22,23 Most institutions release their antibiograms on an annual basis, which normalizes the effects of seasonal variations in bacterial resistance patterns. There are no specific triggers for more frequent hospital antibiograms or their earlier development.…”

Nationwide Antibiogram Analysis Using NCCLS M39-A Guidelines

“…Frequently, such duplicate isolates falsely elevate resistance rates. This has recently been addressed in both the literature and by the NCCLS (10,14,16,22,27), yet only 12% of ABGMs analyzed included some notation of how duplicate isolates from the same patient were managed during the compilation of susceptibility data. The proportion of institutions that report only nonduplicate isolates may be higher than is actually reported on ABGMs (7).…”

Antimicrobial Drug Resistance: Need for An National Policy

“…Antibiotic resistance has not only increased mortality but also has increased in health care cost of hospitalized patient with infections. In many cases bias information gathered from the medical representative, particularly in newer antibiotic has unfortunately lead to irrational prescription of Antibiotic 6 .…”

“…In Thailand it is 75% 6 . No reproducible data is available for us, but assumed that it would be similar to Thailand.…”