UHS and UTHSCSA
Department of Pathology
The “antibiograms" (links below) represent the cumulative antimicrobial susceptibility data from the recent twelve-month period for UH inpatients and outpatients. The report is compiled twice per year and reflects either the entire calendar year or the twelve month-period of July-June. The goal of creating this report is to help guide empiric antibiotic therapy by providing local susceptibility data on the most common organisms. The reports are available on-line or as hard copy pocket guides distributed to the various clinical departments. To obtain a pocket guide if you have not received one, you may call the Microbiology Laboratory at 358-2825.
Antibiogram: January 2014 to December 2014
Staphylococci that are oxacillin-resistant are also resistant to all other
beta-lactam antibiotics (e.g., all cephalosporins [except ceftaroline], meropenem, piperacillin-tazobactam, amoxicillin-clavulanate).
Streptococcus pneumoniae susceptibilities to penicillin and ceftriaxone are reported separately for patients with meningitis, and for patients who do not have meningitis. Isolates reported as susceptible to penicillin–nonmeningitis may be treated with intravenous penicillin G (at least 2 million units q 4h in adults) in patients who have community acquired pneumonia (Peterson, Clin. Infect. Dis. 42: 224-233, 2006). Amoxicillin is more active than oral penicillin against pneumococci. Erythromycin-resistant pneumococci are also resistant to azithromycin and clarithromycin.
Groups A,B,C,F, and G beta-hemolytic streptococci are uniformly susceptible to penicillin, ampicillin, amoxicillin, and first generation cephalosporins. Thus, susceptibility testing is not performed routinely with those drugs. Susceptibility to erythromycin and clindamycin (including inducible resistance to clindamycin) are routinely determined on
all invasive or soft tissue isolates of beta-hemolytic streptococci. Tetracycline is tested to represent doxycycline on all invasive or soft tissue isolates of beta-hemolytic streptococci.
Enterococci that are susceptible to ampicillin cannot be assumed to be susceptible to penicillin. If penicillin results are needed, testing of penicillin is required. Ampicillin-resistant enterococci are resistant to all other beta-lactam antibiotics. Serious enterococcal infections (e.g., endocarditis) require combination therapy with either penicillin/ampicillin or vancomycin and an aminoglycoside (e.g., gentamicin). See gentamicin and streptomycin synergy screen results on susceptibility report.
Enterococci are intrinsically resistant to all cephalosporins and to trimethoprim/sulfamethoxazole.
Haemophilus influenzae isolates are predictably susceptible to amoxicillin/clavulanate and second and third generation cephalosporins.
Antibiotics not reported on this antibiogram (and indicated by a “-“) either lack intrinsic activity against a certain bacterial species, or they are restricted by formulary policy to only certain organisms. If susceptibility results are needed for a non-reported antibiotic for a specific patient, contact the Microbiology Laboratory at ext. 358-2825.
1. The information in the DOLS web site is developed for and intended
to help the clinicians of our academic medical community: The University
Health System; The University of Texas Health Science Center at San Antonio;
The South Texas Veterans Healthcare System: Audie Murphy Memorial Veterans
2. If you are from outside of our community and you find that the information is helpful, you are welcome to it, however, we encourage you to consult with your local experts and your health science center libraries for more information.
Last updated on 05 March 2013 by John D. Olson, M.D.,