Surrogate testing of oral third-generation cephalosporin susceptibility to common uropathogens

Cefazolin susceptibility of urine isolates of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis predicts susceptibility to oral cephalosporins, but cefazolin-resistant isolates may be susceptible to oral third generation cephalosporins. Among 194 urine isolates, we found >95% categorical agreement among oral third-generation cephalosporins. Surrogate testing of cefpodoxime for cefdinir, and vice versa, resulted in no major or very major errors, while combinations involving cefixime produced rare major and very major errors. (c) 2020 Elsevier Inc. All rights reserved.

Automated summary

The susceptibility of urine isolates of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis to cefazolin can predict susceptibility to oral cephalosporins, with cefazolin-resistant isolates potentially still being susceptible to oral third generation cephalosporins. There is over 95% categorical agreement among oral third-generation cephalosporins in 194 urine isolates, and surrogate testing of cefpodoxime for cefdinir showed no major errors.