Antifungal drugs - clinical breakpoints and epidemiological cut-off values.
NRMM recommendations (under discussion; comments invited)

   
 

 

 Current EUCAST recommended MIC breakpoints  Epidemiological cut-off values (preliminary)

S<  and  R> 
(mg/L)

C.albicans


WT<
(mg/L)

 C.parapsilosis
C.tropicalis
C.lusitanie
WT<
(mg/L)		 C.krusei
C.glabrata
 
WT<
(mg/L)
Amphotericin B  1/1TENTATIVE 1 1 1
Caspofungin * * * *
         
Itraconazole * 0.5 0.5 *
Fluconazole (RD) Breakpoints from EUCAST 1 2 >32-64
Voriconazole 1/2CLSI 0.125 0.125 *
         
Flucytosine 4/16CLSI 1 1 C.glabrata: 0.5
C.krusei: 16

*Breakpoint pending

Text = a link to a footnote. If you print the table on paper, remember to print the footnotes - they contain important information on methodology.
4/16 - the way breakpoints are described - interpretate S< 4 mg/l and  R> 16 mg/l.
DS - Clinical effect is not ruled out but the SRGA has not been able to find enough evidence to make a breakpoint decision.
RD - Rationale Document from EUCAST
--  NRMM advices against susceptibility testing. Not a relevant alternative:
  1. insuffcient evidence
  2. insufficient activity
  3. extensive resistance development - the drug may be considered obsolete. 

 

NRMM
Update 2008-02-29