主旨：臨床病理科微生物組整理抗生素可比照藥物通則，請參考。
說明：
一、 由於抗生素種類多，本科微生物檢驗室無法每一種藥物都測試，特別整理相近可比照的藥物使用通則如下：
For Gm(-) bacilli
Imipenem susceptibility may be used to predict the susceptibility to Meropenem
 
For Enterobactericeae
a、 Strains of Klebsiella pnenumonia–ESBL , Klebsiella oxytoca–ESBL and E.coli-ESBL may be clinically resistant to therapy with penicillins, cephalosporins, or aztreonam, despite of apparent in vitro susceptibility to some of these agents
b、 Salmonella spp. and Shigella spp., first- and second-generation cephalosporins may appear active in vitro but are not effective clinically 。
c、 Enterobacter, Citrobacter, and Serratia may develop resistance during prolonged therapy with third-generation cephalosporins. Therefore, consultation of Infectious Diseases is recommended while treating these cases without satisfactory results.
d、 Ceftriaxone susceptibility may be used to predict the susceptibility to Cefotaxime (Claforan), Ceftizoxime (Epocelin), Flomoxef (Flumarin).Cefazolin can be used to predict activity of cephalothin,, cephradine, cephalexin, cefaclor, and cefadroxil.
e、 The sulfisoxazole disk can be used to represent any of the currently available sulfonamide preparations.
 
For Staphylococcus spp.
a、 Penicillin-susceptible staphylococci are also susceptible to other penicillins (such as Oxacillin), cefazolin, Cephradine, and carbapenams (Imepenem or Meropenem).
b、 Oxacillin-resistant staphylococci are resistant to all currently available β-lactams ,includes all penicillins, cephems (such as 1st,2nd and 3rd.cephalosporins like cefazolin ceftriazone etc.), and other β-lactams such as β-lactam and β-lactam inhibitors.
 

For Enterococcus spp.
a、 cephalosporins, aminoglycosides (except for high-level resistance screening), clindamycin, and trimethoprim/sulfamethoxazole may appear active in vitro but are not effective clinically。
b、 The "susceptible" category for penicillin or ampicillin implies the need for high-dose therapy for serious enterococcal infections. Enterococcal endocarditis requires combined therapy with high-dose penicillin or high-dose ampicillin, or vancomycin or teicoplanin plus gentamicin or streptomycin for bactericidal action.
c、 Synergy between ampicillin, penicillin, or vancomycin and an aminoglycoside can be predicted for enterococci by using a high-level aminoglycoside (gentamicin and streptomycin) screening test.
d、 Penicillin susceptibility may be used to predict the susceptibility to Ampicillin, Amoxicillin, Ampicillin/sulbactam, Amoxicillin/claulanic acid, Piperacillin, and Piperacillin/tazobactam.
e、 Ampicillin is the class representative for ampicillin and amoxicillin. Ampicillin results may be used to determine susceptibility to amoxicillin/clavulanic acid and ampicillin/sulbactam among non-β-lactamase-producing enterococci.
 
For Haemophilus spp.
a、 The results of ampicillin susceptibility tests should be used to predict the activity of amoxicillin.
b、 Rare β-lactamase-negative, ampicillin-resistant (BLNAR) strains of H. influenzae should be considered resistant to amoxicillin/clavulanic acid, ampicillin/ sulbactam, cefaclor, cefetamet, cefonicid, cefprozil, cefuroxime, and loracarbef despite apparent in vitro susceptibility of some BLNAR strains to these agents.
 
For S pneumomiae
Ssusceptible to penicillin can be considered susceptible to ampicillin, amoxicillin, amoxicillin/ clavulanic acid, ampicillin/sulbactam, cefaclor, cefdinir, cefepime, cefetamet, cefixime, cefotaxime, cefprozil, ceftibuten, ceftriaxone, cefuroxime, cefpodoxime, ceftizoxime, imipenem, loracarbef, and meropenem
 
For Streptococcus spp.
Isolate that is susceptible to penicillin can be considered susceptible to ampicillin, amoxicillin, amoxicillin/clavulanic acid, ampicillin/sulbactam, cefaclor, cefazolin,cefdinir, cefepime, cefprozil, cefotaxime, ceftibuten (Group A streptococci only), ceftriaxone, cefuroxime, cefpodoxime, ceftizoxime, cephalothin, cephapirin, cephradine, imipenem, loracarbef, and meropenem for approved indications。
 
二、 若有其他有關微生物組藥物感受性試驗問題，請與本科顧問醫師邱政洵或李明勳聯絡。