From Report to Action: Interpreting Antimicrobial Susceptibility in Everyday Clinical Practice

Anne-Marie Dolan (Beaumont Hospital, Dublin, Ireland)

10:35 - 10:40 Tuesday 14 April Morning

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Abstract

Background: Clinician interpretation of antimicrobial susceptibility reports is essential for appropriate infection management. In 2019, the European Committee on Antimicrobial Susceptibility Testing (EUCAST) redefined the “I” category from intermediate to susceptible, increased exposure, indicating that therapeutic success is likely with optimised dosing. At OLOLD, this category is reported as “S*” to address potential prescriber reluctance to use agents labelled as “I.” Aim/Methods: A questionnaire was distributed to clinicians across multiple specialties and training levels to evaluate understanding of antimicrobial susceptibility categories. Results: Forty-four responses were received from seven specialties, including medical (38.6%), surgical (18.2%), and orthopaedic (11.4%) disciplines. Respondents were from all training levels, with 18.2% of respondents identifying as consultants. Most respondents (95.5%) would not prescribe an antibiotic reported as resistant. Only 79.5% would prescribe an antibiotic reported as susceptible on a urine culture. Willingness to prescribe was higher for agents categorised as “S*” (59.1%) compared with “I” (43.2%), despite identical definitions. Conclusion: Significant confusion persists regarding the “S*” and “I” categories, with inconsistent interpretation across all specialties and training levels. The finding that nearly one in five clinicians would not prescribe an antibiotic reported as susceptible highlights the need for enhanced education and continued support from Clinical Microbiologists. We plan further investigation through educational initiatives, followed by a repeat survey. The study will also be extended to other hospitals and include evaluation of alternative reporting mechanisms to identify strategies that improve clinician understanding and optimise antimicrobial use.

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