EUCAST Breakpoints V 2.0 120101

European Committee on Antimicrobial Susceptibility Testing
Breakpoint tables for interpretation of MICs and zone diameters
Version 2.0, valid from 2012-01-01
Content Page
Notes 1
Changes 2
Enterobacteriaceae 3
Pseudomonas spp. 8
Stenotrophomonas maltophilia 12
Acinetobacter spp. 13
Staphylococcus spp. 17
Enterococcus spp. 22
Streptococcus groups A, B, C and G 27
Streptococcus pneumoniae 32
Viridans group streptococci 37
Haemophilus influenzae 41
Moraxella catarrhalis 46
Neisseria gonorrhoeae 50
Neisseria meningitidis 54
Gram-positive anaerobes 58
Clostridium difficile 62
Gram-negative anaerobes 63
Helicobacter pylori 67
Listeria monocytogenes 68
Non-species related breakpoints 69
Notes
1. The EUCAST tables of clinical breakpoints contain clinical MIC breakpoints (determined over the period 2002-2011) and their inhibition zone diameter correlates. The
EUCAST breakpoint table version 2.0 includes corrected typographical errors, clarifications, breakpoints for new organisms, revised MIC breakpoints and revised and new zone
diameter breakpoints. Changes are best seen on screen or on a colour printout since cells containing a change are yellow.
2. Non-species-related breakpoints (Pk/Pd breakpoints) are listed separately on the last page.
3. Numbered footnotes relate to MIC breakpoints. Lettered footnotes relate to zone diameter breakpoints.
4. Highlighted antimicrobial names link to EUCAST rationale documents. Highlighted MIC breakpoints and zone diameter breakpoints link to EUCAST MIC and zone diameter
distributions, respectively.
5. One version of the document is released as an unprotected Excel file to enable users to alter the list of agents to suit the range of agents tested locally and to present
breakpoints in the format used locally. The content of single cells cannot be changed.
Hide lines by right-clicking on the line number and choosing "hide".
Hide columns by right-clicking on the column letter and choosing "hide".
If you wish to add the intermediate columns for MICs and/or zone diameters right-click on the column letter and choose "insert". The intermediate values are inferred from the
"S" and "R" breakpoints.
6. A zone diameter breakpoint of "S ≥ 50 mm" is an arbitrary "off scale" zone diameter breakpoint corresponding to MIC breakpoint situations where wild type isolates are
categorised as intermediate (i.e. no fully susceptible isolates exist).
7. In order to simplify the EUCAST tables, the intermediate category is not listed. It is readily interpreted as the values between the S and the R breakpoint. For example, for
MIC breakpoints listed as S ≤ 1 mg/L and R > 8 mg/L, the intermediate category is 2-8 (technically >1-8) mg/L, and for zone diameter breakpoints listed as S ≥ 22 mm and R <
18 mm, the intermediate category is 18-21 mm.
"-" indicates that susceptibility testing is not recommended as the species is a poor target for therapy with the drug. Isolates may be reported as R without prior testing.
"IE" indicates that there is insufficient evidence that the species in question is a good target for therapy with the drug. An MIC with a comment but without an accompanying S, I
or R categorisation may be reported.
NA = Not Applicable
IP = In Preparation
1
Table Changes (cells containing a change, a deletion or an addition) from v 1.3 are marked yellow
All • Instructions for disk diffusion methodology and quality control included.
• Typo error on trimethoprim-sulfamethoxazole corrected to 1.25-23.75 µg.
• Telavancin breakpoints added.
Enterobacteriaceae • Revised breakpoints: Ampicillin, ampicillin-sulbactam, amoxicillin, amoxicillin-clavulanate, piperacillin-tazobactam, cefotaxime, ceftibuten, imipenem and tobramycin. Ticarcillin and ticarcillin-
clavulanate (typo errors).
• Disk content (30 μg) for cefoxitin added.
• Ceftibuten: "uncomplicated UTI only" is changed to "UTI only".
• Revised comments: Penicillins, ampicillin, mecillinam comment F and imipenem.
Pseudomonas spp. • Revised breakpoints: Doripenem and fosfomycin. Trimethoprim-sulfamethoxazole breakpoint for Stenotrophomonas maltophilia moved to a separate table.
• Revised comment: Fosfomycin.
Stenotrophomonas maltophilia • New table.
• Revised comments: Trimethoprim-sulfamethoxazole.
Staphylococcus spp. • Revised breakpoints: Vancomycin (specific breakpoints for S. aureus and coagulase-negative staphylococci).
• Revised comments: Penicillins, glycopeptides and doxycycline.
Enterococcus spp. • Revised breakpoints: Mupirocin.
• Revised comments: Penicillins, amoxicillin-clavulanate and nitrofurantoin. General recommendation for endocarditis added.
Streptococcus groups A, B, C and G • Revised breakpoints: Mupirocin and trimethoprim.
• Revised comments: Benzylpenicillin, phenoxymethylpenicillin, doxycycline and trimethoprim.
Stretococcus pneumoniae • Typo error on benzylpenicillin note corrected. Correct dosages are 1.2 and 2.4 g.
• Revised breakpoints: Ceftibuten, linezolid (typo error on MIC breakpoint) and mupirocin.
• Revised comments: Penicillins (several comments merged), benzylpenicillin, ampicillin, ampicillin-sulbactam, phenoxymethylpenicillin and doxycyline. Benzylpenicillin and meropenem
(breakpoints for meningitis moved to a separate row).
Viridans group streptococci • "Other streptococci" changed to "Viridans group streptococci". General recommendation for endocarditis added.
(Other streptococci) • Revised breakpoints: Benzylpenicillin (screen) and mupirocin.
Haemophilus influenzae • Revised breakpoints: Benzylpenicillin (screen), amoxicillin, amoxicillin-clavulanate, phenoxymethylpenicillin (screen breakpoint removed), cefepime, cefixime, cefotaxime, cefpodoxime,
ceftibuten, ceftriaxone, cefuroxime, cefuroxime-axetil, imipenem, ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin, minocycline, tetracycline, chloramphenicol and rifampicin.
• Disk content for amoxicillin-clavulanate changed to 2-1 µg.
• Revised comments: Benzylpenicillin, ampicillin, piperacillin, cefaclor, meropenem and doxycycline.
Moraxella catarrhalis • Revised breakpoints: Ampicillin, amoxicillin, amoxicillin-clavulanate, piperacillin, cefaclor, cefepime, cefixime, cefpodoxime, ceftibuten, cefuroxime, cefuroxime-axetil, azithromycin,
chloramphenicol and rifampicin.
• Disk content for amoxicillin-clavulanate changed to 2-1 µg.
• Revised comments: Cefaclor and doxycycline.
Neisseria gonorrhoeae • Revised comment: Doxycycline.
Gram-positive anaerobes • New comment: Ampicillin-sulbactam, amoxicillin-clavulanate, piperacillin-tazobactam and ticarcillin-clavulanate.
Clostridium difficile • New table. All breakpoints and comments new.
Gram-negative anaerobes • Revised breakpoints: Teicoplanin.
• New comment: Ampicillin-sulbactam, amoxicillin-clavulanate, piperacillin-tazobactam and ticarcillin-clavulanate.
Miscellaneous • Table removed. Organisms with breakpoints have new tables.
Helicobacter pylori • New table. All breakpoints and comments new.
Listeria monocytogenes • New table. All breakpoints new.
Non-species related • Revised breakpoints: Nalidixic acid, vancomycin and teicoplanin.
• Revised comments: Teicoplanin and vancomycin.
• "Uncomplicated UTI only" removed from antibiotic names.
2
Enterobacteriaceae EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
Disk diffusion (EUCAST standardised disk diffusion method)

Medium: Mueller-Hinton agar
Inoculum: McFarland 0.5
Incubation: Air, 35±1ºC, 18±2h
Reading: Read zone edges as the point showing no growth viewed from the back of the plate against a black background
illuminated with reflected light.
Quality control: Escherichia coli ATCC 25922
Penicillins1 MIC breakpoint Disk Zone diameter Notes

(mg/L) content breakpoint (mm) Numbers for comments on MIC breakpoints
(µg) Letters for comments on disk diffusion
S≤ R> S≥ R<
Benzylpenicillin - - - -
Ampicillin 81 8 10 14A,B 14B 1/A. Wild type Enterobacteriaceae are categorised as susceptible to aminopenicillins.
Some countries prefer to categorise wild type isolates of E. coli and P. mirabilis as intermediate. When this is the case, use the
MIC breakpoint S ≤ 0.5 mg/L and the corresponding zone diameter breakpoint S ≥50 mm.
B. Ignore growth that may appear as a thin inner zone on some batches of Mueller-Hinton agars.
Ampicillin-sulbactam 81,2 82 10-10 14A,B 14B 2. For susceptibility testing purposes, the concentration of sulbactam is fixed at 4 mg/L.
Amoxicillin 81 8 - NoteC NoteC C. Susceptibility inferred from ampicillin.
Amoxicillin-clavulanate 81,3 83 20-10 17A,B 17B 3. For susceptibility testing purposes, the concentration of clavulanate is fixed at 2 mg/L.
Piperacillin 8 16 30 18 15
Piperacillin-tazobactam 84 164 30-6 20 17 4. For susceptibility testing purposes, the concentration of tazobactam is fixed at 4 mg/L.
Ticarcillin 8 16 75 23 23
Ticarcillin-clavulanate 83 163 75-10 23 23
Phenoxymethylpenicillin - - - -
Oxacillin - - - -
Cloxacillin - - - -
Dicloxacillin - - - -
Flucloxacillin - - - -
Mecillinam (uncomplicated UTI only) 85 85 10 15E,F 15E, F 5/E. Mecillinam (pivmecillinam) breakpoints relate to E. coli, Klebsiella spp. and P. mirabilis only.
F. Ignore isolated colonies within the inhibition zone for E. coli.
3
Cephalosporins1 MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
1. The cephalosporin breakpoints for Enterobacteriaceae will detect all clinically important resistance mechanisms (including ESBL
and plasmid mediated AmpC). Some isolates that produce beta-lactamases are susceptible or intermediate to 3rd or 4th
generation cephalosporins with these breakpoints and should be reported as tested, i.e. the presence or absence of an ESBL
does not in itself influence the categorisation of susceptibility. In many areas, ESBL detection and characterisation is
recommended or mandatory for infection control purposes.
Cefaclor - - - -
Cefadroxil (uncomplicated UTI only) 16 16 30 12 12
Cefalexin (uncomplicated UTI only) 16 16 30 12 12
Cefazolin - - - -
Cefepime 1 4 30 24 21
Cefixime (uncomplicated UTI only) 1 1 5 17 17
Cefotaxime 1 2 5 20 17
Cefoxitin (screen)2 NA NA 30 19 19 2. The cefoxitin ECOFF (WT ≤ 8 mg/L) has a high sensitivity, but poor specificity for identification of AmpC-producing
Enterobacteriaceae as this antibiotic is also affected by permeability alterations and some carbapenemases. Classical non-AmpC
producers are wild type, whereas plasmid AmpC producers or chromosomal AmpC hyperproducers are non-wild type.
Cefpodoxime (uncomplicated UTI only) 1 1 10 21 21
Ceftazidime 1 4 10 22 19
Ceftibuten (UTI only) 1 1 30 23 23
Ceftriaxone 1 2 30 23 20
Cefuroxime 83 8 30 18 18 3. The breakpoint relates to a dosage of 1.5 g x 3 and to E. coli, P. mirabilis and Klebsiella spp. only.
Cefuroxime axetil (uncomplicated UTI only) 8 8 30 18 18
Carbapenems1 MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
1. The carbapenem breakpoints for Enterobacteriaceae will detect all clinically important resistance mechanisms (including the
majority of carbapenemases). Some isolates that produce carbapenemase are categorised as susceptible with these breakpoints
and should be reported as tested, i.e. the presence or absence of a carbapenemase does not in itself influence the categorisation
of susceptibility. In many areas, carbapenemase detection and characterisation is recommended or mandatory for infection control
purposes.
Doripenem 1 4 10 24 18
Ertapenem 0.5 1 10 25 22
Imipenem2 2 8 10 22 16 2. Low-level resistance is common in Morganella spp., Proteus spp. and Providencia spp.
Meropenem 2 8 10 22 16
4
Monobactams MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Aztreonam1 1 4 30 27 24 1. The aztreonam breakpoints for Enterobacteriaceae will detect clinically important resistance mechanisms (including ESBL).
Some isolates that produce beta-lactamases are susceptible or intermediate to 3rd or 4th generation cephalosporins with these
breakpoints and should be reported as tested, i.e. the presence or absence of an ESBL does not in itself influence the
categorisation of susceptibility. In many areas, ESBL detection and characterisation is recommended or mandatory for infection
control purposes.
Fluoroquinolones MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Ciprofloxacin1 0.5 1 5 22 19 1. Salmonella spp. - there is clinical evidence for ciprofloxacin to indicate a poor response in systemic infections caused by
Salmonella spp. with low-level fluoroquinolone resistance (MIC>0.06 mg/L). The available data relate mainly to S. typhi but there
are also case reports of poor response with other Salmonella species.
Levofloxacin 1 2 5 22 19
Moxifloxacin 0.5 1 5 20 17
Nalidixic acid (screen) NA NA NA NA
Norfloxacin 0.5 1 10 22 19
Ofloxacin 0.5 1 5 22 19
Aminoglycosides1 MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
1. Aminoglycoside breakpoints are based on once-daily administration of high aminoglycoside dosages. Most often
aminoglycosides are given in combination with beta-lactam agents.
Amikacin 8 16 30 16 13
Gentamicin 2 4 10 17 14
Netilmicin 2 4 10 15 12
Tobramycin 2 4 10 17 14
5
Glycopeptides MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Teicoplanin - - - -
Telavancin - - - -
Vancomycin - - - -
Macrolides, lincosamides and streptogramins MIC breakpoint Disk Zone diameter Notes
S≤ R> S≥ R<
Azithromycin1 - - - - 1. Azithromycin has been used in the treatment of infections with Salmonella typhi (MIC ≤16 mg/L for wild type isolates) and
Shigella spp.
Clarithromycin - - - -
Erythromycin1 - - - -
Roxithromycin - - - -
Telithromycin - - - -
Clindamycin - - - -
Quinupristin-dalfopristin - - - -
6
Tetracyclines MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Doxycycline - - - -
Minocycline - - - -
Tetracycline - - - -
Tigecycline1 1 2 15 18A 15A 1. Tigecycline has decreased activity against Morganella spp., Proteus spp. and Providencia spp.
A. Zone diameter breakpoints validated for E. coli only. For other Enterobacteriaceae, use an MIC method.
Miscellaneous agents MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Chloramphenicol 8 8 30 17 17
Colistin 2 2 NoteA NoteA A. Use an MIC method.
Daptomycin - - - -
Fosfomycin iv 32 32 - -
Fosfomycin-trometamol (uncomplicated UTI only) 32 32 - -
Fusidic acid - - - -
Linezolid - - - -
Metronidazole - - - -
Mupirocin - - - -
Nitrofurantoin (uncomplicated UTI only) 641 641 100 11B 11B 1/B. Breakpoints relate to E. coli only.
Rifampicin - - - -
Spectinomycin - - - -
Trimethoprim (uncomplicated UTI only) 2 4 5 18 15
Trimethoprim-sulfamethoxazole2 2 4 1.25-23.75 16 13 2. Trimethoprim:sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration.
7
Pseudomonas spp. EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

Quality control: Pseudomonas aeruginosa ATCC 27853
Penicillins MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Ampicillin - - - -
Ampicillin-sulbactam - - - -
Amoxicillin - - - -
Amoxicillin-clavulanate - - - -
Piperacillin1 16 16 30 19 19 1. Breakpoints are based on high dose therapy (with or without tazobactam, 4 g x 4).
Piperacillin-tazobactam1 162 162 30-6 19 19 2. For susceptibility testing purposes, the concentration of beta-lactamase inhibitor is fixed at 4 mg/L.
Ticarcillin3 16 16 75 17 17 3. Breakpoints are based on high dose therapy (with or without clavulanate, 3 g x 4).
Ticarcillin-clavulanate3 162 162 75-10 17 17
Oxacillin - - - -
Cloxacillin - - - -
Mecillinam (uncomplicated UTI only) - - - -
8
Cephalosporins MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Cefaclor - - - -
Cefadroxil - - - -
Cefalexin - - - -
Cefazolin - - - -
Cefepime 81 8 30 18 18 1. Breakpoints relate to high dose therapy (2 g x 3).
Cefixime - - - -
Cefotaxime - - - -
Cefoxitin NA NA NA NA
Cefpodoxime - - - -
Ceftazidime 81 8 10 16 16
Ceftibuten - - - -
Ceftriaxone - - - -
Cefuroxime - - - -
Cefuroxime axetil - - - -
Carbapenems MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Ertapenem - - - -
Imipenem 41 8 10 20 17 1. Breakpoints relate to high dose, frequent therapy (1 g x 4).

S≤ R> S≥ R<
Aztreonam 1 161 30 50 16 1. The resistant breakpoint relates to high dose therapy. The susceptible breakpoint is set to ensure that wild type isolates are
reported intermediate.
9

S≤ R> S≥ R<
Ciprofloxacin 0.5 1 5 25 22
Moxifloxacin - - - -
Norfloxacin - - - -
Ofloxacin - - - -

S≤ R> S≥ R<
Amikacin 8 16 30 18 15

S≤ R> S≥ R<
Teicoplanin - - - -
Telavancin - - - -
Vancomycin - - - -
10
S≤ R> S≥ R<
Azithromycin - - - -
Erythromycin - - - -
Clindamycin - - - -

S≤ R> S≥ R<
Doxycycline - - - -
Minocycline - - - -
Tigecycline - - - -
Miscellaneous MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Chloramphenicol - - - -
Daptomycin - - - -
Fosfomycin iv1 - - - - 1. Anecdotal evidence suggests that infections caused by wild type isolates (ECOFF: WT ≤ 128 mg/L) may be treated with
combinations of fosfomycin and other agents.
Fosfomycin-trometamol (uncomplicated UTI only) - - - -
Linezolid - - - -
Mupirocin - - - -
Nitrofurantoin (uncomplicated UTI only) - - - -
Rifampicin - - - -
Trimethoprim (uncomplicated UTI only) - - - -
Trimethoprim-sulfamethoxazole - - - -
11
Stenotrophomonas maltophilia EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

Quality control: Escherichia coli ATCC 25922
Antibiotic agent MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Trimethoprim-sulfamethoxazole1 4 4 1.25-23.75 16A 16A 1. Trimethoprim:sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration.
A. Ignore haze or fine growth within the inhibition zone.
12
Acinetobacter spp. EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

Quality control: Pseudomonas aeruginosa ATCC 27853

S≤ R> S≥ R<
1. Susceptibility testing of Acinetobacter spp. to penicillins is unreliable. In most instances Acinetobacter spp. are resistant to
penicillins.
Ampicillin - - - -
Ampicillin-sulbactam IE IE IE IE
Amoxicillin - - - -
Amoxicillin-clavulanate - - - -
Piperacillin IE IE IE IE
Piperacillin-tazobactam IE IE IE IE
Ticarcillin IE IE IE IE
Ticarcillin-clavulanate IE IE IE IE
Oxacillin - - - -
Cloxacillin - - - -
13

S≤ R> S≥ R<
Cefaclor - - - -
Cefadroxil - - - -
Cefalexin - - - -
Cefazolin - - - -
Cefepime - - - -
Cefixime - - - -
Cefotaxime - - - -
Cefoxitin - - - -
Cefpodoxime - - - -
Ceftazidime - - - -
Ceftibuten - - - -
Ceftriaxone - - - -
Cefuroxime - - - -

S≤ R> S≥ R<
Ertapenem - - - -
Imipenem 2 8 10 23 17

S≤ R> S≥ R<
Aztreonam - - - -
14

S≤ R> S≥ R<
Ciprofloxacin 1 1 5 21 21
Norfloxacin - - - -
Ofloxacin - - - -

S≤ R> S≥ R<
Amikacin 8 16 30 18 15

S≤ R> S≥ R<
Teicoplanin - - - -
Telavancin - - - -
Vancomycin - - - -
15
S≤ R> S≥ R<
Clindamycin - - - -

S≤ R> S≥ R<
Doxycycline - - - -
Minocycline IE IE IE IE
Tigecycline IE IE IE IE

S≤ R> S≥ R<
Daptomycin - - - -
Fosfomycin iv - - - -
Linezolid - - - -
Mupirocin - - - -
Rifampicin - - - -
16
Staphylococcus spp. EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

Quality control: Staphylococcus aureus ATCC 29213

S≤ R> S≥ R<
1/A. Most staphylococci are penicillinase producers. The benzylpenicillin breakpoint will mostly, but not unequivocally, separate
beta-lactamase producers from non-producers. If the MIC is >0.12 mg/L, report resistant. If the MIC is ≤0.12mg/L, test
susceptibility with a disk diffusion test (see note B).
Isolates positive for beta-lactamase are resistant to benzylpenicillin, phenoxymethylpenicillin, amino-, carboxy- and
ureidopenicillins. Isolates negative for beta-lactamase and susceptible to cefoxitin (cefoxitin is used to screen for “methicillin
resistance”) can be reported susceptible to these drugs.
Isolates positive for beta-lactamase and susceptible to cefoxitin are susceptible to penicillin-beta-lactamase inhibitor combinations
and penicillinase-resistant penicillins (oxacillin, cloxacillin, dicloxacillin and flucloxacillin).
Isolates resistant to cefoxitin are methicillin resistant and resistant to beta-lactam agents, except those with approved anti-MRSA
activity and clinical breakpoints.
Benzylpenicillin 0.121 0.121,2 1 unit 26A,B 26A,B B. Disk diffusion is more reliable than MIC for detection of penicillinase producers, provided the zone diameter is measured AND
the zone edge closely inspected. If the zone diameter is <26 mm, report resistant. If the zone diameter is ≥26 mm and the zone
edge is sharp, report resistant. If not sharp, report susceptible and if uncertain, report resistant.
Chromogenic cephalosporin-based beta-lactamase tests do not reliably detect staphylococcal penicillinase.
Ampicillin Note1 Note1 2 15A,C 15A,C C. Breakpoints relate to S. saprophyticus only.
Ampicillin-sulbactam Note1 Note1 NoteA NoteA
Amoxicillin Note1 Note1 NoteA NoteA
Amoxicillin-clavulanate Note1 Note1 NoteA NoteA
Piperacillin Note1 Note1 NoteA NoteA
Piperacillin-tazobactam Note1 Note1 NoteA NoteA
Ticarcillin Note1 Note1 NoteA NoteA
Ticarcillin-clavulanate Note1 Note1 NoteA NoteA
Phenoxymethylpenicillin Note1 Note1 NoteA NoteA
Oxacillin2 Note1,2 Note1,2 NoteA NoteA 2. S. aureus and S. lugdunensis with oxacillin MIC values >2 mg/L are mostly methicillin resistant due to the presence of the
mecA gene. The corresponding oxacillin MIC for coagulase-negative staphylococci is >0.25 mg/L.
Cloxacillin Note1 Note1 NoteA NoteA
Dicloxacillin Note1 Note1 NoteA NoteA
Flucloxacillin Note1 Note1 NoteA NoteA
17

S≤ R> S≥ R<
1. Susceptibility of staphylococci to cephalosporins is inferred from the cefoxitin susceptibility except for ceftazidime, cefixime and
ceftibuten, which do not have breakpoints and should not be used for staphylococcal infections.
Cefaclor2 Note1 Note1 NoteA NoteA 2. High-dose therapy is required for treatment of staphylococcal infections.
A. Susceptibility inferred from cefoxitin.
Cefadroxil Note1 Note1 NoteA NoteA
1 1 A
Cefalexin Note Note Note NoteA
Cefazolin Note1 Note1 NoteA NoteA
Cefepime Note1 Note1 NoteA NoteA
Cefixime - - - -
Cefotaxime Note1 Note1 NoteA NoteA
Cefoxitin (screen) S. aureus, S. lugdunensis Note3 Note3 30 22A 22A 3. S. aureus and S. lugdunensis with cefoxitin MIC values >4 mg/L are mostly methicillin resistant due to the presence of the
mecA gene. For coagulase-negative staphylococi other than S. lugdunensis the cefoxitin MIC is a poorer predictor of methicillin
resistance than the disk diffusion test.
Cefoxitin (screen) Coagulase-negative staphylococci Note3 Note3 30 25A 25A
1 1 A
Cefpodoxime Note Note Note NoteA
Ceftazidime - - - -
Ceftibuten IE IE IE IE
Ceftriaxone Note1 Note1 NoteA NoteA
Cefuroxime Note1 Note1 NoteA NoteA
1 1 A
Cefuroxime axetil Note Note Note NoteA

S≤ R> S≥ R<
1/A. Susceptibility of staphylococci to carbapenems is inferred from the cefoxitin susceptibility.
Doripenem Note1 Note1 NoteA NoteA
Ertapenem Note1 Note1 NoteA NoteA
Imipenem Note1 Note1 NoteA NoteA
Meropenem Note1 Note1 NoteA NoteA
18

S≤ R> S≥ R<
Aztreonam - - - -
Fluoroquinolones1 MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
1. Regarding breakpoints for other fluoroquinolones (e.g. pefloxacin and enoxacin) - refer to breakpoints determined by national
breakpoint committees.
Ciprofloxacin2 1 1 5 20 20 2. Breakpoints relate to high dose therapy.
Norfloxacin (screen) NA NA 10 17A 17A A. The norfloxacin disk diffusion test can be used to screen for fluoroquinolone resistance. Isolates categorised as susceptible can
be reported susceptible to ciprofloxacin, levofloxacin, moxifloxacin and ofloxacin. Isolates categorised as resistant should be tested
for susceptibility to individual agents.
Ofloxacin2 1 1 5 20 20

S≤ R> S≥ R<
Amikacin2 S. aureus 8 16 30 18 16 2. Resistance to amikacin is most reliably determined by testing with kanamycin (zone diameter breakpoints under development).
Amikacin2 Coagulase-negative staphylococci 8 16 30 22 19
Gentamicin S. aureus 1 1 10 18 18
Gentamicin Coagulase-negative staphylococci 1 1 10 22 22
Netilmicin S. aureus 1 1 10 18 18
Netilmicin Coagulase-negative staphylococci 1 1 10 22 22
Tobramycin S. aureus 1 1 10 18 18
Tobramycin Coagulase-negative staphylococci 1 1 10 22 22
19
Glycopeptides1 MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
1. Glycopeptide MICs are method dependent and should be determined by broth microdilution (reference ISO 20776). S. aureus
with vancomycin MIC values of 2 mg/L are on the border of the wild type MIC distribution and there may be an impaired clinical
response. The resistant breakpoint has been reduced to 2 mg/L to avoid reporting "GISA" isolates intermediate as serious
infections with "GISA" isolates are not treatable with increased doses of vancomycin or teicoplanin.
Teicoplanin, S. aureus 2 2 NoteA NoteA A. Disk diffusion is unreliable and cannot distinguish between wild type isolates and those with non-vanA -mediated resistance.
A
Teicoplanin, Coagulase-negative staphylococci 4 4 Note NoteA
Telavancin, MRSA 1 1 NoteA NoteA
A
Vancomycin, S. aureus 2 2 Note NoteA
Vancomycin, Coagulase-negative staphylococci 4 4 NoteA NoteA
S≤ R> S≥ R<
Azithromycin 11 21 NoteA NoteA 1/A. Erythromycin can be used to determine susceptibility to azithromycin, clarithromycin and roxithromycin.
1 1 A
Clarithromycin 1 2 Note NoteA
Erythromycin 1 2 15 21 18
Roxithromycin 11 21 NoteA NoteA
Telithromycin IE IE IE IE
Clindamycin2 0.25 0.5 2 22B 19B 2/B. Inducible clindamycin resistance can be detected only in the presence of a macrolide antibiotic. In disk diffusion tests look for
apparent antagonism of clindamycin by erythromycin (D-test).
Quinupristin-dalfopristin 1 2 15 21C 18C C. Isolates non-susceptible by disk diffusion should be confirmed by MIC testing.

S≤ R> S≥ R<
Doxycycline 11 21 NoteA NoteA 1/A. Isolates susceptible to tetracycline are also susceptible to doxycycline and minocycline, but some resistant to tetracycline may
be susceptible to minocycline and/or doxycycline. An MIC method should be used to test doxycycline susceptibility of tetracycline
resistant isolates if required.
Minocycline 0.51 11 30 23A 20A
Tetracycline 11 21 30 22A 19A
2 0.5 18 18
Tigecycline 0.5 15 2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
susceptibility tests on any such isolate must be repeated and if the result is confirmed the isolate sent to a reference laboratory.
Until there is evidence regarding clinical response for confirmed isolates with MIC values above the current resistant breakpoint
they should be reported resistant.
20

S≤ R> S≥ R<
Colistin - - - -
Daptomycin 1 11 NoteA NoteA 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
A. Use an MIC method.
Fosfomycin iv 32 32 NoteA NoteA
Fusidic acid 1 1 10 24 24
Linezolid 4 4 10 19 19
Mupirocin 12 2562 200 30B 18B 2/B. Breakpoints relate to nasal decolonisation of S. aureus. Intermediate isolates are initially cleared as effectively as susceptible
isolates but recolonisation is very common.
Nitrofurantoin (uncomplicated UTI only) 643 643 100 13C 13C 3/C. Breakpoints relate to S. saprophyticus only.
Rifampicin 0.06 0.5 5 26 23
Trimethoprim (uncomplicated UTI only) 2 4 5 17 14
21
Enterococcus spp. EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
In endocarditis, refer to national or international Disk diffusion (EUCAST standardised disk diffusion method)
endocarditis guidelines for breakpoints for Medium: Mueller-Hinton agar
Enterococcus spp. Inoculum: McFarland 0.5
Quality control: Enterococcus faecalis ATCC 29212

S≤ R> S≥ R<
1. E. faecium resistant to penicillins can be considered resistant to all other beta-lactam agents including carbapenems.
Ampicillin 4 8 2 10 8
Ampicillin-sulbactam2 4 8 NoteA NoteA 2/A. Susceptibility to ampicillin, amoxicillin and pipercillin with and without beta-lactamase inhibitor can be inferred from the
ampicillin susceptibility test.
Amoxicillin2 4 8 NoteA NoteA
Amoxicillin-clavulanate2 43 83 NoteA NoteA 3. For susceptibility testing purposes, the concentration of clavulanate is fixed at 2 mg/L.
Piperacillin2 Note2 Note2 NoteA NoteA
Piperacillin-tazobactam2 Note2 Note2 NoteA NoteA
Ticarcillin - - - -
Ticarcillin-clavulanate - - - -
Oxacillin - - - -
Cloxacillin - - - -
22

S≤ R> S≥ R<
Cefaclor - - - -
Cefadroxil - - - -
Cefalexin - - - -
Cefazolin - - - -
Cefepime - - - -
Cefixime - - - -
Cefotaxime - - - -
Cefoxitin - - - -
Cefpodoxime - - - -
Ceftazidime - - - -
Ceftibuten - - - -
Ceftriaxone - - - -
Cefuroxime - - - -

S≤ R> S≥ R<
Doripenem - - - -
Ertapenem - - - -
Imipenem 4 8 10 21 18
Meropenem - - - -

S≤ R> S≥ R<
Aztreonam - - - -
23

S≤ R> S≥ R<
Ciprofloxacin - - - -
Levofloxacin - - - -
Norfloxacin - - - -
Ofloxacin - - - -

S≤ R> S≥ R<
1. Aminoglycoside monotherapy is ineffective against enterococci. There is synergism between aminoglycosides and beta-lactam
agents against enterococci without acquired aminoglycoside resistance mechanisms.
Amikacin IE IE NoteA NoteA
Gentamicin Note2 Note2 30 NoteA NoteA 2/A. Isolates with gentamicin MIC >128 mg/L or an inhibition zone diameter <8 mm have acquired resistance mechanisms and can
be reported as high-level aminoglycoside resistant (with the exception of streptomycin, which must be tested separately). There is
no synergistic effect between aminoglycosides and beta-lactam agents in enterococci with high-level aminoglycoside resistance.
Netilmicin IE IE NoteA NoteA
3 3 B
Streptomycin Note Note 300 Note NoteB 3/B. Isolates with high-level gentamicin resistance may not be high-level resistant to streptomycin. High-level resistance to
streptomycin is defined as MIC >512 mg/L and/or an inhibition zone diameter <19 mm. There is no synergistic effect between
streptomycin and beta-lactam agents in enterococci with high-level resistance to streptomycin.
Tobramycin IE IE NoteA NoteA
24

S≤ R> S≥ R<
Teicoplanin 21 2 30 16A 16A 1. The susceptible breakpoint for vancomycin has been raised to 4 mg/L to avoid dividing the wild type MIC distributions of some
species. The resistant breakpoint for teicoplanin has been reduced to 2 mg/L to avoid erroneous reporting of isolates with vanA -
mediated resistance.
A. Glycopeptide susceptible enterococci exhibit sharp zone edges. Suspect resistance when the zone edge is fuzzy or colonies
grow within the inhibition zone. Some vanB isolates (vancomycin resistant, teicoplanin susceptible) are particularly difficult to
detect with disk diffusion.
Telavancin IE IE IE IE
Vancomycin 41 4 5 12A 12A
S≤ R> S≥ R<
- -
Clindamycin - - - -
Quinupristin-dalfopristin 11 41 15 22A 20A 1/A. Quinupristin-dalfopristin breakpoints are valid for E. faecium only.
25

S≤ R> S≥ R<
Doxycycline - - - -
Minocycline - - - -
Tigecycline 0.251 0.5 15 18 15 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial

S≤ R> S≥ R<
Colistin - - - -
Daptomycin IE IE IE IE
Mupirocin - - - -
Nitrofurantoin (uncomplicated UTI only) 641 641 100 15A 15A 1/A. Nitrofurantoin breakpoints are valid for E. faecalis only.
Rifampicin - - - -
Trimethoprim (uncomplicated UTI only)2 0.03 1 5 50 21 2. The activity of trimethoprim is uncertain against enterococci, hence the wild type population is categorised as intermediate.
Trimethoprim-sulfamethoxazole3 0.03 1 1.25-23.75 50 21 3. Trimethoprim-sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration.
26
Streptococcus groups A, B, C and G EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

Medium: Mueller-Hinton agar + 5% defibrinated horse blood and 20 mg/L β-NAD (MH-F)
Incubation: 5% CO2, 35±1ºC, 18±2h
Reading: Read zone edges as the point showing no growth viewed from the front of the plate with the lid removed and with
reflected light.
Quality control: Streptococcus pneumoniae ATCC 49619

S≤ R> S≥ R<
1/A. The beta-lactam susceptibility of beta-haemolytic streptococcus groups A, B, C and G is inferred from the penicillin
susceptibility.
Benzylpenicillin2 0.25 0.25 1 unit 18 18 2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
Ampicillin Note1 Note1 NoteA NoteA
Ampicillin-sulbactam3 Note1 Note1 NoteA NoteA 3. Streptococcus groups A, B, C and G do not produce beta-lactamase. The addition of a beta-lactamase inhibitor does not add
clinical benefit.
Amoxicillin Note1 Note1 NoteA NoteA
Amoxicillin-clavulanate3 Note1 Note1 NoteA NoteA
1 1 A
Piperacillin Note Note Note NoteA
1 1 A
Piperacillin-tazobactam 3
Note Note Note NoteA
Ticarcillin - - - -
Phenoxymethylpenicillin Note1,4 Note1,4 NoteA,B NoteA,B 4/B. The phenoxymethylpenicillin breakpoints apply to streptococcus groups A, C and G only.
Oxacillin NA NA NA NA
Cloxacillin Note1 Note1 NoteA NoteA
Dicloxacillin Note1 Note1 NoteA NoteA
Flucloxacillin Note1 Note1 NoteA NoteA
27

S≤ R> S≥ R<
susceptibility.
Cefaclor Note1 Note1 NoteA NoteA
1 1 A
Cefadroxil Note Note Note NoteA
1 1 A
Cefalexin Note Note Note NoteA
Cefazolin Note1 Note1 NoteA NoteA
1 1 A
Cefepime Note Note Note NoteA
Cefixime - - - -
Cefotaxime Note1 Note1 NoteA NoteA
Cefpodoxime Note1 Note1 NoteA NoteA
Ceftazidime - - - -
Ceftibuten Note1 Note1 NoteA NoteA
Ceftriaxone Note1 Note1 NoteA NoteA
1 1 A
Cefuroxime Note Note Note NoteA
1 1 A
Cefuroxime axetil Note Note Note NoteA

S≤ R> S≥ R<
susceptibility.
Doripenem Note1 Note1 NoteA NoteA
Ertapenem Note1 Note1 NoteA NoteA
Imipenem Note1 Note1 NoteA NoteA
Meropenem Note1 Note1 NoteA NoteA

S≤ R> S≥ R<
Aztreonam - - - -
28

S≤ R> S≥ R<
Norfloxacin (screen) NA NA 10 12A 12A A. The norfloxacin disk diffusion test can be used to screen for fluoroquinolone resistance. Isolates categorised as susceptible can
be reported susceptible to levofloxacin and moxifloxacin. Isolates categorised as resistant should be tested for susceptibility to
individual agents.
Ofloxacin - - - -
Aminoglycosides MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
Amikacin - - - -
Gentamicin - - - -
Netilmicin - - - -
Tobramycin - - - -

S≤ R> S≥ R<
Teicoplanin 21 2 30 15A 15A 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
A. Zone diameter breakpoints are based on wild type distributions as there are currently no resistant isolates.
29
S≤ R> S≥ R<
Azithromycin 0.251 0.51 NoteA NoteA 1/A. Erythromycin can be used to determine susceptibility to azithromycin, clarithromycin and roxithromycin.
1 1 A
Clarithromycin 0.25 0.5 Note NoteA
Erythromycin 0.25 0.5 15 21 18
Roxithromycin 0.51 11 NoteA NoteA
Telithromycin 0.25 0.5 15 22 19

S≤ R> S≥ R<
Tigecycline 0.252 0.5 15 19 16 2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
30

S≤ R> S≥ R<
Colistin - - - -
Daptomycin 11 1 NoteA NoteA 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
A. Use an MIC method.
Fusidic acid IE IE IE IE
Mupirocin - - - -
Nitrofurantoin (uncomplicated UTI only) 642 642 100 15B 15B 2/B. Nitrofurantoin breakpoints apply to S. agalactiae (group B streptococci) only.
Rifampicin 0.06 0.5 5 21 15
Trimethoprim (uncomplicated UTI only) 23 23 5 IP IP 3. Trimethoprim breakpoints apply to S. agalactiae (group B streptococci) only.
Trimethoprim-sulfamethoxazole4 1 2 1.25-23.75 18 15 4. Trimethoprim-sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration.
31
Streptococcus pneumoniae EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

Inoculum: McFarland 0.5 from blood agar or McFarland 1.0 from chocolate agar
reflected light.

S≤ R> S≥ R<
1. Most MIC values for penicillin, ampicillin, amoxicillin and piperacillin (with or without a beta-lactamase inhibitor) differ by no more
than one dilution step and isolates fully susceptible to benzylpenicillin (MIC ≤0.06 mg/L; susceptible by oxacillin disk screen, see
note A) can be reported susceptible to beta-lactam agents that have been given breakpoints.
A. Screen for beta-lactam resistance with the oxacillin 1 μg disk. Isolates categorised as susceptible can be reported susceptible
to benzylpenicillin, phenoxymethylpenicillin and aminopenicillins (with or without beta-lactamase inhibitor) irrespective of clinical
indication. Isolates categorised as oxacillin resistant can be reported resistant to phenoxymethylpenicillin and to benzylpenicillin in
meningitis. For other beta-lactams, determine the MIC of the agent considered for clinical use.
Benzylpenicillin (infections other than meningitis) 0.061,2 21,2 1 unit NoteA NoteA 2. In pneumonia, when a dose of 1.2 g x 4 is used, isolates with MIC ≤0.5 mg/L should be regarded as susceptible to
benzylpenicillin.
In pneumonia, when a dose of 2.4 g x 4 or 1.2 g x 6 is used, isolates with MIC ≤1 mg/L should be regarded as susceptible to
benzylpenicillin.
In pneumonia, when a dose of 2.4 g x 6 is used, isolates with MIC ≤2 mg/L should be regarded as susceptible.
Benzylpenicillin (meningitis) 0.061 0.061 1 unit NoteA NoteA
1 1 A
Ampicillin 0.5 2 2 23 20A
Ampicillin-sulbactam Note1 Note1 NoteA,B NoteA,B B. Susceptibility inferred from ampicillin.
Amoxicillin Note1 Note1 NoteA,B NoteA,B
Amoxicillin-clavulanate Note1 Note1 NoteA,B NoteA,B
Piperacillin Note1 Note1 NoteA,B NoteA,B
1 1 A,B
Piperacillin-tazobactam Note Note Note NoteA,B
Ticarcillin - - - -
Phenoxymethylpenicillin Note1 Note1 NoteA NoteA
Oxacillin (screen) NA NA 1 20A 20A

Cloxacillin - - - -
32

S≤ R> S≥ R<
Cefaclor 0.03 0.5 30 50 28

Cefadroxil - - - -
Cefalexin - - - -
Cefazolin - - - -
Cefepime 11 2 NoteA NoteA 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
to cefepime, cefotaxime, cefpodoxime, ceftriaxone, cefuroxime and cefuroxime axetil.
Isolates categorised as oxacillin resistant should be tested with an MIC method with the agent considered for clinical use.
Cefixime - - - -
Cefotaxime 0.51 2 NoteA NoteA
Cefpodoxime 0.25 0.5 NoteA NoteA
Ceftazidime - - - -
Ceftibuten - - - -
Ceftriaxone 0.51 2 NoteA NoteA
Cefuroxime 0.5 1 NoteA NoteA
Cefuroxime axetil 0.25 0.5 NoteA NoteA

S≤ R> S≥ R<
Doripenem1 12 1 NoteA NoteA 1. Not for meningitis (meropenem is the only carbapenem used for meningitis).
2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
to doripenem, ertapenem, imipenem and meropenem. Isolates categorised as oxacillin resistant should be tested by an MIC
method.
Ertapenem1 0.52 0.5 NoteA NoteA

Imipenem1 22 2 NoteA NoteA
A
Meropenem (infections other than meningitis) 3 2 2 Note NoteA 3. Meropenem is the only carbapenem used for meningitis.
A,B
Meropenem (meningitis) 3 0.25 1 Note NoteA,B B. For use in meningitis determine the meropenem MIC.
33

S≤ R> S≥ R<
Aztreonam - - - -
Fluoroquinolones1 MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
1/A. The norfloxacin disk diffusion test can be used to screen for fluoroquinolone resistance. Isolates categorised as susceptible
can be reported susceptible to levofloxacin and moxifloxacin and intermediate to ciprofloxacin and ofloxacin. Isolates categorised
as resistant should be tested for susceptibility to individual agents.
Ciprofloxacin2 0.12 2 5 50A 18A 2. Wild type S. pneumoniae are not considered susceptible to ciprofloxacin and are therefore categorised as intermediate.
Levofloxacin3 2 2 5 19A 19A 3. The breakpoints for levofloxacin relate to high dose therapy.
Moxifloxacin 0.5 0.5 5 22A 22A
Norfloxacin (screen) NA NA 10 12A 12A
A
Ofloxacin 4 0.12 4 5 50 15A 4. Wild type S. pneumoniae are not considered susceptible to ofloxacin and are therefore categorised as intermediate.

S≤ R> S≥ R<
Amikacin - - - -
Gentamicin - - - -
Netilmicin - - - -
Tobramycin - - - -
34

S≤ R> S≥ R<
S≤ R> S≥ R<
Clarithromycin 0.251 0.51 NoteA NoteA
35

S≤ R> S≥ R<

S≤ R> S≥ R<
Colistin - - - -
Daptomycin IE IE IE IE
Fosfomycin iv IE IE IE IE
Mupirocin - - - -
Rifampicin 0.06 0.5 5 22 17
36
Viridans group streptococci EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
In endocarditis, refer to national or international Disk diffusion (EUCAST standardised disk diffusion method)
endocarditis guidelines for breakpoints for viridans Medium: Mueller-Hinton agar + 5% defibrinated horse blood and 20 mg/L β-NAD (MH-F)
group streptococci. Inoculum: McFarland 0.5
Reading: Read zone edges as the point showing no growth viewed from the front of the platewith the lid removed and with
reflected light.

S≤ R> S≥ R<
Benzylpenicillin 0.25 2 1 unit 18 12

Benzylpenicillin (screen) NA NA 1 unit 18A 18A A. Benzylpenicillin 1 unit can be used to screen for beta-lactam resistance in viridans group streptococci. Isolates categorised as
susceptible can be reported susceptible to beta-lactam agents for which clinical breakpoints are listed. Isolates categorised as
resistant should be tested for susceptibility to individual agents.
Ampicillin 0.5 2 2 21 15
Ampicillin-sulbactam Note1 Note1 NoteB NoteB 1/B. For isolates susceptible to benzylpenicillin, susceptibility can be inferred from benzylpenicillin or ampicillin. For isolates
resistant to benzylpenicillin, susceptibility is inferred from ampicillin.
Amoxicillin 0.5 2 NoteB NoteB
1 1 B
Amoxicillin-clavulanate Note Note Note NoteB
1 1 B
Piperacillin Note Note Note NoteB
Piperacillin-tazobactam Note1 Note1 NoteB NoteB
Phenoxymethylpenicillin IE IE IE IE
Oxacillin - - - -
Cloxacillin - - - -
37

S≤ R> S≥ R<
Cefaclor - - - -
Cefadroxil - - - -
Cefalexin - - - -
Cefazolin 0.5 0.5 30 IP IP
Cefepime 0.5 0.5 30 25 25
Cefixime - - - -
Cefotaxime 0.5 0.5 5 23 23
Cefpodoxime - - - -
Ceftazidime - - - -
Ceftibuten - - - -
Ceftriaxone 0.5 0.5 30 27 27
Cefuroxime 0.5 0.5 30 26 26

S≤ R> S≥ R<
Doripenem 11 1 10 25 25 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
Ertapenem 0.51 0.5 10 22 22
Imipenem 21 2 10 30 30
Meropenem 21 2 10 25 25

S≤ R> S≥ R<
Aztreonam - - - -
38

S≤ R> S≥ R<
Levofloxacin - - - -
Norfloxacin - - - -
Ofloxacin - - - -

S≤ R> S≥ R<
Amikacin - - - -
Gentamicin - - - -
Netilmicin - - - -
Tobramycin - - - -

S≤ R> S≥ R<
39
S≤ R> S≥ R<
Azithromycin IE IE IE IE
Clarithromycin IE IE IE IE
Erythromycin IE IE IE IE
Roxithromycin IE IE IE IE
Telithromycin IE IE IE IE
Clindamycin1 0.5 0.5 2 19A 19A 1/A. Inducible clindamycin resistance can be detected only in the presence of a macrolide antibiotic. In disk diffusion tests look for
Quinupristin-dalfopristin IE IE IE IE

S≤ R> S≥ R<
Doxycycline - - - -
Minocycline - - - -

S≤ R> S≥ R<
Colistin - - - -
Daptomycin - - - -
Linezolid - - - -
Mupirocin - - - -
Rifampicin - - - -
Trimethoprim-sulfamethoxazole - - - -
40
Haemophilus influenzae EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

reflected light.
Quality control: Haemophilus influenzae NCTC 8468

S≤ R> S≥ R<
Benzylpenicillin IE IE IE IE
Benzylpenicillin (screen) NA NA 1 unit 12A 12A A. Benzylpenicillin can be used to screen for but not to distinguish between beta-lactamase producing isolates and isolates with
PBP changes. Isolates categorised as resistant with the screen breakpoint should be checked for beta-lactamase and non-beta-
lactamase-mediated resistance to aminopenicillins (without and with inhibitors), cephalosporins and/or carbapenems.
Ampicillin 11 11 2 16 16 1. Breakpoints apply to beta-lactamase negative isolates only. Report beta-lactamase positive isolates resistant to penicillins
without beta-lactamase inhibitors.
Ampicillin-sulbactam 12,3 12,3 10-10 NoteB NoteB 2. For susceptibility testing purposes, the concentration of sulbactam is fixed at 4 mg/L.
3/B. Susceptibility can be inferred from amoxicillin-clavulanate.
Amoxicillin 21 21 NoteC NoteC C. Susceptibility inferred from ampicillin.
Amoxicillin-clavulanate 24 24 2-1 17 17 4. For susceptibility testing purposes, the concentration of clavulanate is fixed at 2 mg/L.
Piperacillin Note1,5 Note1,5 NoteD NoteD 5/D. Susceptibility inferred from ampicillin or amoxicillin.
Piperacillin-tazobactam Note3 Note3 NoteB NoteB
Phenoxymethylpenicillin IE IE IE IE
Oxacillin - - - -
Cloxacillin - - - -
41

S≤ R> S≥ R<
Cefaclor 0.51 0.5 NA NA 1. MIC breakpoints render all H.influenzae resistant to cefaclor.
Cefadroxil - - - -
Cefalexin - - - -
Cefazolin - - - -
Cefepime 0.252 0.25 30 27 27 2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
Cefixime 0.122 0.12 5 25 25
Cefotaxime 0.122 0.12 5 26 26
Cefpodoxime 0.252 0.5 10 26 23
Ceftazidime - - - -
Ceftibuten 12 1 30 25 25
Ceftriaxone 0.122 0.12 30 30 30
Cefuroxime 1 2 30 26 25
Cefuroxime axetil 0.12 1 30 50 26

S≤ R> S≥ R<
Doripenem1 12 1 10 20 20 1. Not for meningitis (meropenem is the only carbapenem used for meningitis).
2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
Ertapenem1 0.52 0.5 10 20 20
Imipenem 1
22 2 10 20 20
Meropenem (infections other than meningitis)3 22 2 10 20A 20A 3. Meropenem is the only carbapenem used for meningitis.
Meropenem (meningitis)3 0.25 1 NoteA NoteA A. For use in meningitis determine the meropenem MIC value.
42

S≤ R> S≥ R<
Aztreonam IE IE IE IE
Fluoroquinolones1,2 MIC breakpoint Disk Zone diameter Notes

S≤ R> S≥ R<
1. Low-level fluoroquinolone resistance (ciprofloxacin MICs of 0.12-0.5 mg/L) may occur but there is no evidence that this
resistance is of clinical importance in respiratory tract infections with H. influenzae .
Ciprofloxacin 0.52 0.5 5 26 26 2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
Moxifloxacin 0.52 0.5 5 25 25
Nalidixic acid (screen) NA NA 30 23A 23A A. The nalidixic acid disk diffusion test can be used to screen for fluoroquinolone resistance. Isolates with zone diameters ≥23 mm
can be reported susceptible to levofloxacin, ciprofloxacin, moxifloxacin and ofloxacin. Isolates with zone diameters <23 mm may
have fluoroquinolone resistance and should be tested against the appropriate agent.
Norfloxacin - - - -
Ofloxacin 0.52 0.5 5 23 23

S≤ R> S≥ R<
Amikacin IE IE IE IE
Gentamicin IE IE IE IE
Netilmicin IE IE IE IE
Tobramycin IE IE IE IE
43

content
(mg/L) breakpoint (mm) Numbers for comments on MIC breakpoints
(µg)
Letters for comments on disk diffusion
S≤ R> S≥ R<
Teicoplanin - - - -
Telavancin - - - -
Vancomycin - - - -
Macrolides1, lincosamides and streptogramins MIC breakpoint Disk Zone diameter Notes
S≤ R> S≥ R<
1. Correlation between macrolide MICs and clinical outcome is weak for H. influenzae . Therefore, breakpoints for macrolides and
related antibiotics have been set to categorise wild type H. influenzae as intermediate.
Azithromycin 0.122 42 NoteA NoteA 2/A. Erythromycin can be used to determine susceptibility to azithromycin, clarithromycin and roxithromycin.
2 2 A
Clarithromycin 1 32 Note NoteA
Erythromycin 0.5 16 15 50 10
Roxithromycin 12 162 NoteA NoteA
Telithromycin 0.12 8 15 50 12
Clindamycin - - - -
44

S≤ R> S≥ R<
Minocycline 11 21 30 24A 21A
Miscellaneous agents MIC breakpoint Zone diameter

(mg/L) breakpoint (mm)
S≤ R> S≥ R<
Colistin - - - -
Daptomycin - - - -
Linezolid - - - -
Mupirocin - - - -
Rifampicin (for prophylaxis only) 1 1 5 18 18
Trimethoprim-sulfamethoxazole1 0.5 1 1.25-23.75 23 20 1. Trimethoprim:sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration.
45
Moraxella catarrhalis EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

reflected light.
Quality control: Haemophilus influenzae NCTC 8468

S≤ R> S≥ R<
Ampicillin -1 -1 - - 1. Most M. catarrhalis produce beta-lactamase, although beta-lactamase production is slow and may give weak results with in
vitro tests. Beta-lactamase producers should be reported resistant to penicillins and aminopenicillins without inhibitors.
Ampicillin-sulbactam 12,3 12,3 NoteA NoteA 2. For susceptibility testing purposes, the concentration of sulbactam is fixed at 4 mg/L.
3/A. Susceptibility can be inferred from amoxicillin-clavulanate.
Amoxicillin -1 -1 - -
4
Amoxicillin-clavulanate 1 14 2-1 19 19 4. For susceptibility testing purposes, the concentration of clavulanate is fixed at 2 mg/L.
Piperacillin -1 -1 - -
3
Piperacillin-tazobactam Note Note3 NoteA NoteA
Oxacillin - - - -
Cloxacillin - - - -
46

S≤ R> S≥ R<
Cefaclor 0.121 0.121 - - 1. MIC breakpoints render all M. catarrhalis resistant to cefaclor.
Cefadroxil - - - -
Cefalexin - - - -
Cefazolin - - - -
Cefepime 4 4 30 20 20
Cefixime 0.5 1 5 21 18
Cefotaxime 1 2 5 20 17
Cefpodoxime IP IP 10 IP IP
Ceftazidime - - - -
Ceftibuten IE IE IE IE
Ceftriaxone 1 2 30 24 21
Cefuroxime 4 8 30 21 18
Cefuroxime axetil 0.12 4 30 50 21

S≤ R> S≥ R<
Doripenem 11 1 10 30 30 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial
Ertapenem 0.51 0.5 10 29 29
Imipenem 21 2 10 29 29
Meropenem 21 2 10 33 33

S≤ R> S≥ R<
Aztreonam IE IE IE IE
47

S≤ R> S≥ R<
Ciprofloxacin 0.5 0.5 5 23 23

Moxifloxacin 0.5 0.5 5 23 23
Nalidixic acid NA NA 30 23A 23A A. The nalidixic acid disk diffusion test can be used to screen for fluoroquinolone resistance. Isolates with zone diameters ≥23 mm
can be reported susceptible to levofloxacin, ciprofloxacin, moxifloxacin and ofloxacin. Isolates with zone diameters <23 mm may
have fluoroquinolone resistance and should be tested against the appropriate agent.
Norfloxacin - - - -
Ofloxacin 0.5 0.5 5 25 25

S≤ R> S≥ R<
Amikacin IE IE IE IE
Gentamicin IE IE IE IE
Netilmicin IE IE IE IE
Tobramycin IE IE IE IE

S≤ R> S≥ R<
Teicoplanin - - - -
Telavancin - - - -
Vancomycin - - - -
48
S≤ R> S≥ R<
Clarithromycin 0.251 0.51 NoteA NoteA
Clindamycin - - - -

S≤ R> S≥ R<
Minocycline 11 21 30 25A 22A
Tetracycline 1 2 30 28 25

S≤ R> S≥ R<
Chloramphenicol 21 21 30 30A 30A 1/A. Breakpoints relate to the topical use of chloramphenicol.
Colistin - - - -
Daptomycin - - - -
Linezolid - - - -
Mupirocin - - - -
Rifampicin - - - -
Trimethoprim-sulfamethoxazole1 0.5 1 1.25-23.75 18 15 1. Trimethoprim:sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration.
49
Neisseria gonorrhoeae EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
Penicillins1 MIC breakpoint Notes

(mg/L) Numbers for comments on MIC breakpoints
Disk diffusion criteria for antimicrobial susceptibility testing of Neisseria gonorrhoeae have
S≤ R > not yet been determined.
1. Always test for beta-lactamase. If positive, report resistant to benzylpenicillin, ampicillin and amoxicillin. The
susceptibility of beta-lactamase negative isolates to ampicillin and amoxicillin can be inferred from the
susceptibility to benzylpenicillin.
Benzylpenicillin 0.06 1
Ampicillin1 Note1 Note1
Ampicillin-sulbactam IE IE
Amoxicillin1 Note1 Note1
1
Amoxicillin-clavulanate Note Note1
Piperacillin - -
Piperacillin-tazobactam - -
Ticarcillin - -
Ticarcillin-clavulanate - -
Phenoxymethylpenicillin - -
Oxacillin - -
Cloxacillin - -
Dicloxacillin - -
Flucloxacillin - -
Mecillinam (uncomplicated UTI only) - -
50
Cephalosporins MIC breakpoint Notes

Cefaclor - -
Cefadroxil - -
Cefalexin - -
Cefazolin - -
Cefepime - -
Cefixime1 0.12 0.12 1. Neisseria gonorrhoeae without resistance mechanisms to cefixime have MICs of ≤0.06 mg/L and can be
treated with current standard dosing. The implications of alternative dosing schedules and recent data relating
MIC to outcome are under consideration.
Cefotaxime 0.12 0.12
Cefoxitin - -
Cefpodoxime IE IE
Ceftazidime - -
Ceftibuten IE IE
Ceftriaxone 0.12 0.12
Cefuroxime - -
Cefuroxime axetil - -
Carbapenems MIC breakpoint Notes

Doripenem IE IE
Ertapenem IE IE
Imipenem IE IE
Meropenem IE IE
Monobactams MIC breakpoint Notes

Aztreonam IE IE
51
Fluoroquinolones1 MIC breakpoint Notes

Ciprofloxacin 0.03 0.06

Levofloxacin IE IE
Moxifloxacin IE IE
Nalidixic acid (screen) NA NA
Norfloxacin IE IE
Ofloxacin 0.12 0.25
Aminoglycosides MIC breakpoint Notes

Amikacin - -
Gentamicin - -
Netilmicin - -
Tobramycin - -
Glycopeptides MIC breakpoint Notes

Teicoplanin - -
Telavancin - -
Vancomycin - -
52
Macrolides, lincosamides and MIC breakpoint Notes

streptogramins (mg/L) Numbers for comments on MIC breakpoints
Azithromycin 0.25 0.5

Clarithromycin - -
Erythromycin - -
Roxithromycin - -
Telithromycin - -
Clindamycin - -
Quinupristin-dalfopristin - -
Tetracyclines1 MIC breakpoint Notes

1. Isolates susceptible to tetracycline are also susceptible to minocycline, but some isolates resistant to
tetracycline may be susceptible to minocycline.
Doxycycline IE IE
Minocycline 0.5 1
Tetracycline 0.5 1
Tigecycline IE IE
Miscellaneous agents MIC breakpoint Notes

Chloramphenicol - -
Colistin - -
Daptomycin - -
Fosfomycin iv - -
Fosfomycin-trometamol (uncomplicated UTI only) - -
Fusidic acid - -
Linezolid - -
Metronidazole - -
Mupirocin - -
Nitrofurantoin (uncomplicated UTI only) - -
Rifampicin - -
Spectinomycin 64 64
Trimethoprim (uncomplicated UTI only) - -
Trimethoprim-sulfamethoxazole - -
53
Neisseria meningitidis EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
Penicillins MIC breakpoint Notes

Disk diffusion criteria for antimicrobial susceptibility testing of Neisseria meningitidis have
Benzylpenicillin 0.06 0.25

Ampicillin 0.12 1
Ampicillin-sulbactam IE IE
Amoxicillin 0.12 1
Amoxicillin-clavulanate - -
Piperacillin - -
Piperacillin-tazobactam - -
Ticarcillin - -
Ticarcillin-clavulanate - -
Phenoxymethylpenicillin - -
Oxacillin - -
Cloxacillin - -
Dicloxacillin - -
Flucloxacillin - -
54

Cefaclor - -
Cefadroxil - -
Cefalexin - -
Cefazolin - -
Cefepime - -
Cefixime - -
Cefotaxime 0.121 0.12 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification
and antimicrobial susceptibility tests on any such isolate must be repeated and if the result is confirmed the
isolate sent to a reference laboratory. Until there is evidence regarding clinical response for confirmed isolates
with MIC values above the current resistant breakpoint they should be reported resistant.
Cefoxitin
Cefpodoxime - -
Ceftazidime - -
Ceftibuten - -
Ceftriaxone 0.121 0.12
Cefuroxime - -

Doripenem IE IE
Ertapenem - -
Imipenem - -
Meropenem1 0.252 0.25 1. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification
and antimicrobial susceptibility tests on any such isolate must be repeated and if the result is confirmed the
isolate sent to a reference laboratory. Until there is evidence regarding clinical response for confirmed isolates
with MIC values above the current resistant breakpoint they should be reported resistant.
2. Breakpoints relate to meningitis only.

Aztreonam - -
55
Fluoroquinolones MIC breakpoint Notes

Ciprofloxacin 0.031 0.061 1. Breakpoints apply only to use in the prophylaxis of meningococcal disease.
Levofloxacin IE IE
Moxifloxacin IE IE
Norfloxacin - -
Ofloxacin IE IE

Amikacin - -
Gentamicin - -
Netilmicin - -
Tobramycin - -

Teicoplanin - -
Telavancin - -
Vancomycin - -
56

Azithromycin - -
Clarithromycin - -
Erythromycin - -
Roxithromycin - -
Telithromycin - -
Clindamycin - -
Quinupristin-dalfopristin - -
Tetracyclines MIC breakpoint Notes

Doxycycline - -
Minocycline1 1 2 1. Tetracycline can be used to predict susceptibility to minocycline for prophylaxis against N. meningitidis
infections.
Tetracycline 1 2
Tigecycline IE IE

Chloramphenicol 2 4
Colistin - -
Daptomycin - -
Fosfomycin iv - -
Fusidic acid - -
Linezolid - -
Metronidazole - -
Mupirocin - -
Rifampicin1 0.25 0.25 1. For prophylaxis of meningitis only (refer to national guidelines).
Spectinomycin - -
57
Gram-positive anaerobes EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
except Clostridium difficile

Disk diffusion criteria for antimicrobial susceptibility testing of anaerobes have not yet been
S≤ R > determined.
Benzylpenicillin1 0.25 0.5 1. Susceptibility to ampicillin, amoxicillin and piperacillin without beta-lactamase inhibitors can be inferred from
Ampicillin 4 8
Ampicillin-sulbactam 42 82 2. For susceptibility testing purposes, the concentration of sulbactam is fixed at 4 mg/L.
Amoxicillin 4 8
Amoxicillin-clavulanate 43 83 3. For susceptibility testing purposes, the concentration of clavulanate is fixed at 2 mg/L.
Piperacillin 8 16
Piperacillin-tazobactam 84 164 4. For susceptibility testing purposes, the concentration of tazobactam is fixed at 4 mg/L.
Ticarcillin 8 16
Ticarcillin-clavulanate 83 163
Phenoxymethylpenicillin IE IE
Oxacillin - -
Cloxacillin - -
Dicloxacillin - -
Flucloxacillin - -

Cefaclor - -
Cefadroxil - -
Cefalexin - -
Cefazolin - -
Cefepime - -
Cefixime - -
Cefotaxime - -
Cefoxitin
Cefpodoxime - -
Ceftazidime - -
Ceftibuten - -
Ceftriaxone - -
Cefuroxime - -
58

Doripenem 1 1
Ertapenem 1 1
Imipenem 2 8
Meropenem 2 8

Aztreonam - -

Ciprofloxacin - -
Levofloxacin - -
Moxifloxacin IE IE
Norfloxacin - -
Ofloxacin - -
59

Amikacin - -
Gentamicin - -
Netilmicin - -
Tobramycin - -

Teicoplanin IE IE
Telavancin IE IE
Vancomycin 2 2

Azithromycin - -
Clarithromycin - -
Erythromycin IE IE
Roxithromycin - -
Telithromycin - -
Clindamycin 4 4
Quinupristin/dalfopristin - -
60

1. For anaerobic bacteria there is clinical evidence of activity in mixed intra-abdominal infections, but no
correlation between MIC values, Pk/Pd data and clinical outcome. Therefore no breakpoints for susceptibility
testing are given.
Doxycycline1 Note1 Note1
Minocycline1 Note1 Note1
Tetracycline1 Note1 Note1
Tigecycline1 Note1 Note1

Chloramphenicol 8 8
Colistin - -
Daptomycin - -
Fosfomycin iv - -
Fusidic acid - -
Linezolid - -
Metronidazole 4 4
Mupirocin - -
Rifampicin - -
Spectinomycin - -
61
Clostridium difficile EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
Antibiotic agent MIC breakpoint Notes

Disk diffusion criteria for antimicrobial susceptibility testing of Clostridium difficile have not
S≤ R > yet been determined.
Daptomycin -1 -1 1. Not used clinically. May be tested for epidemiological purposes only (ECOFF: WT ≤ 4 mg/L).
Fusidic acid -2 -2 2. Not used clinically. May be tested for epidemiological purposes only (ECOFF: WT ≤ 2 mg/L).
Metronidazole 23 23 3. The breakpoints are based on epidemiological cut-off values (ECOFFs), which distinguish wild-type isolates
from those with reduced susceptibility.
Moxifloxacin -4 -4 4. Not used clinically. May be tested for epidemiological purposes only (ECOFF: WT ≤ 4 mg/L).
Tigecycline -5 -5 5. Not used clinically. May be tested for epidemiological purposes only (ECOFF: WT ≤ 0.25 mg/L).
Rifampicin - 6
-6 6. Not used clinically. May be tested for epidemiological purposes only (ECOFF: WT ≤ 0.004 mg/L).
Vancomycin 23 23
62
Gram-negative anaerobes EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01

Benzylpenicillin1 0.25 0.5 1. Susceptibility to ampicillin, amoxicillin and piperacillin without beta-lactamase inhibitors can be inferred from
Ampicillin1 0.5 2
Ampicillin-sulbactam1 42 82 2. For susceptibility testing purposes, the concentration of sulbactam is fixed at 4 mg/L.
Amoxicillin1 0.5 2
Amoxicillin-clavulanate1 43 83 3. For susceptibility testing purposes, the concentration of clavulanate is fixed at 2 mg/L.
1 16 16
Piperacillin
Piperacillin-tazobactam1 84 164 4. For susceptibility testing purposes, the concentration of tazobactam is fixed at 4 mg/L.
Ticarcillin1 16 16
Ticarcillin-clavulanate1 83 163
Oxacillin - -
Cloxacillin - -
Dicloxacillin - -
Flucloxacillin - -

Cefaclor - -
Cefadroxil - -
Cefalexin - -
Cefazolin - -
Cefepime - -
Cefixime - -
Cefotaxime - -
Cefoxitin NA NA
Cefpodoxime - -
Ceftazidime - -
Ceftibuten - -
Ceftriaxone - -
Cefuroxime - -
63

Doripenem 1 1
Ertapenem 1 1
Imipenem 2 8
Meropenem 2 8

Aztreonam - -

Ciprofloxacin - -
Levofloxacin - -
Moxifloxacin IE IE
Norfloxacin - -
Ofloxacin - -
64

Amikacin - -
Gentamicin - -
Netilmicin - -
Tobramycin - -

Teicoplanin - -
Telavancin - -
Vancomycin - -

Azithromycin - -
Clarithromycin - -
Erythromycin IE IE
Roxithromycin - -
Telithromycin - -
Clindamycin 4 4
Quinupristin/dalfopristin - -
65

1. For anaerobic bacteria there is clinical evidence of activity in mixed intra-abdominal infections, but no
correlation between MIC values, Pk/Pd data and clinical outcome. Therefore no breakpoints for susceptibility
testing are given.
Doxycycline1 Note1 Note1
1
Minocycline 1
Note Note1
Tetracycline1 Note1 Note1
1
Tigecycline 1
Note Note1

Chloramphenicol 8 8
Colistin - -
Daptomycin - -
Fosfomycin iv - -
Fusidic acid - -
Linezolid - -
Metronidazole 4 4
Mupirocin - -
Rifampicin - -
Spectinomycin - -
66
Helicobacter pylori EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
Antibiotic agent MIC breakpoint Notes

S≤ R>
1. The breakpoints are based on epidemiological cut-off values (ECOFFs), which distinguish wild-type isolates
from those with reduced susceptibility.
Amoxicillin 0.121 0.121
1
Clarithromycin 0.25 0.51
Levofloxacin 11 11
Metronidazole 81 81
Rifampicin 11 11
Tetracycline 11 11
67
Listeria monocytogenes EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
Disk diffusion (EUCAST standardised disk diffusion method )

reflected light.
Antibiotic agent MIC breakpoint Disk Zone diameter Notes

S≤ R> (µg) S≥ R < Letters for comments on disk diffusion
Ampicillin 1 1 2 16 16
Benzylpenicillin 1 1 1 unit 13 13
Erythromycin 1 1 15 25 25
Meropenem 0.25 0.25 10 26 26
Trimethoprim-sulfamethoxazole1 0.06 0.06 1.25-23.75 29 29 1. Trimethoprim-sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration.
68
Non-species related breakpoints EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01
Penicillins MIC breakpoint Non-species related breakpoints are based on the following dosages
(mg/L) (See section 8 in Rationale Documents)
S≤ R>
Benzylpenicillin 0.25 2 The non-species related S/I and I/R breakpoints are based on 600 mg x 4 (2.4 g/day) and 2.4 g x 6 (14.4 g/day)
doses respectively.
Ampicillin 2 8 The non-species related breakpoints are based on doses of at least 0.5 g x 3-4 (1.5-2 g/day).
Ampicillin-sulbactam 2 8 Rationale document in preparation.
Amoxicillin 2 8 The non-species related breakpoints are based on doses of at least 0.5 g x 3-4 (1.5-2 g/day).
Amoxicillin-clavulanate 2 8 Rationale document in preparation.
Piperacillin 4 16 Breakpoints apply to piperacillin-tazobactam dosage of 4 g x 3.
Piperacillin-tazobactam 4 16 Breakpoints apply to piperacillin-tazobactam dosage of 4 g x 3.
Ticarcillin 8 16
Ticarcillin-clavulanate 8 16
Oxacillin IE IE
Cloxacillin IE IE
Dicloxacillin IE IE
Flucloxacillin IE IE
Mecillinam IE IE
Cephalosporins MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Cefaclor IE IE
Cefadroxil IE IE
Cefalexin IE IE
Cefazolin 1 2 Rationale document in preparation.
Cefepime 4 8 Breakpoints apply to a daily intravenous dose of 2 g x 2 and a high dose of at least 2 g x 3.
Cefixime IE IE
Cefotaxime 1 2 Breakpoints apply to a daily intravenous dose of 1 g x 3 and a high dose of at least 2 g x 3.
Cefoxitin IE IE
Cefpodoxime IE IE
Ceftazidime 4 8 Breakpoints apply to a daily intravenous dose of 1 g x 3 and a high dose of at least 2 g x 3.
Ceftibuten IE IE
Ceftriaxone 1 2 Breakpoints apply to a daily intravenous dose of 1 g x 1 and a high dose of at least 2 g x 1.
Cefuroxime 4 8 Breakpoints apply to a daily intravenous dose of 750 mg x 3 and a high dose of at least 1.5 g x 3.
Cefuroxime axetil IE IE
69
Carbapenems MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Doripenem 1 4 EUCAST breakpoints apply to doripenem 500 mg x 3 daily administered intravenously over 1 hour as the lowest
dose. 500 mg x 3 daily administered over 4 hours was taken into consideration for severe infections and in setting
the I/R breakpoint.
Ertapenem 0.5 1 EUCAST breakpoints apply to ertapenem 1000 mg x 1 daily administered intravenously over 30 minutes as the
only dose.
Imipenem 2 8 EUCAST breakpoints apply to imipenem 500 mg x 4 daily administered intravenously over 30 minutes as the
lowest dose. 1 g x 4 daily was taken into consideration for severe infections and in setting the I/R breakpoint.
Meropenem 2 8 EUCAST breakpoints apply to meropenem 1000 mg x 3 daily administered intravenously over 30 minutes as the
lowest dose. 2 g x 3 daily was taken into consideration for severe infections and in setting the I/R breakpoint.
Monobactams MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Aztreonam 4 8 Rationale document in preparation.
Fluoroquinolones MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Ciprofloxacin 0.5 1 Breakpoints apply to an oral dose of 500 mg x 2 (or as low as 250 mg x 2 for uncomplicated urinary tract
infections) to 750 mg x 2 and an intravenous dose of 400 mg x 2 to 400 mg x 3.
Levofloxacin 1 2 Breakpoints apply to an oral dose of 500 mg x 1 to 500 mg x 2 and an intravenous dose of 500 mg x 1 to 500 mg
x 2.
Moxifloxacin 0.5 1 Breakpoints apply to an oral and iv dose of 400 mg x 1.
Nalidixic acid IE IE
Norfloxacin 0.5 1 Breakpoints apply to an oral dose of 400 mg x 2.
Ofloxacin 0.5 1 Breakpoints apply to an oral dose of 200 mg x 2 to 400 mg x 2 and an intravenous dose of 200 mg x 2 to 400 mg
x 2.
70
Aminoglycosides MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Amikacin 8 16 EUCAST breakpoints apply to intravenous amikacin dosage of 15 mg/kg/day. In the absence of Pk/Pd data these
have been determined mainly on the basis of Pk data and pre-existing breakpoints.
Gentamicin 2 4 Breakpoints apply to intravenous gentamicin dosage of 3-4.5 mg/kg/day. In the absence of Pk/Pd data these have
been determined mainly on the basis of Pk data and pre-existing breakpoints.
Netilmicin 2 4 Breakpoints apply to intravenous netilmicin dosage of 4-6 mg/kg/day. In the absence of Pk/Pd data these have
been determined mainly on the basis of Pk data and pre-existing breakpoints.
Tobramycin 2 4 EUCAST breakpoints apply to intravenous tobramycin dosage of 3-4.5 mg/kg/day. In the absence of Pk/Pd data
these have been determined mainly on the basis of Pk data and pre-existing breakpoints.
Glycopeptides MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Teicoplanin IE IE
Telavancin IE IE
Vancomycin IE IE
Macrolides, lincosamides and streptogramins MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Azithromycin IE IE
Clarithromycin IE IE
Erythromycin IE IE
Roxithromycin IE IE
Telithromycin IE IE
Clindamycin IE IE
Quinupristin/dalfopristin IE IE
71
Tetracyclines MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Doxycycline IE IE
Minocycline IE IE
Tetracycline IE IE
Tigecycline 0.25 0.5 Breakpoints apply to a tigecycline intravenous dose of 100 mg followed by 50 mg 12 hourly for CSSSI and CIAI.
Miscellaneous MIC breakpoint Non-species related breakpoints are based on the following dosages
S≤ R>
Chloramphenicol IE IE
Colistin IE IE
Daptomycin IE IE
Fosfomycin iv IE IE
Fosfomycin-trometamol IE IE
Fusidic acid IE IE
Linezolid 2 4 Breakpoints apply to a linezolid intravenous and oral dosage of 600 mg x 2.
Metronidazole IE IE
Mupirocin IE IE
Nitrofurantoin IE IE
Rifampicin IE IE
Spectinomycin IE IE
Trimethoprim IE IE
Trimethoprim-sulfamethoxazole IE IE
72

EUCAST Breakpoints V 2.0 120101

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European Committee on Antimicrobial Susceptibility Testing

Breakpoint tables for interpretation of MICs and zone diameters

Version 2.0, valid from 2012-01-01

Disk diffusion (EUCAST standardised disk diffusion method)

Penicillins1 MIC breakpoint Disk Zone diameter Notes

Cephalosporins1 MIC breakpoint Disk Zone diameter Notes

Carbapenems1 MIC breakpoint Disk Zone diameter Notes

Monobactams MIC breakpoint Disk Zone diameter Notes

Fluoroquinolones MIC breakpoint Disk Zone diameter Notes

Aminoglycosides1 MIC breakpoint Disk Zone diameter Notes

Glycopeptides MIC breakpoint Disk Zone diameter Notes

Tetracyclines MIC breakpoint Disk Zone diameter Notes

Miscellaneous agents MIC breakpoint Disk Zone diameter Notes

Disk diffusion (EUCAST standardised disk diffusion method)

Penicillins MIC breakpoint Disk Zone diameter Notes

Mecillinam (uncomplicated UTI only) - - - -

Cephalosporins MIC breakpoint Disk Zone diameter Notes

Carbapenems MIC breakpoint Disk Zone diameter Notes

Monobactams MIC breakpoint Disk Zone diameter Notes

Fluoroquinolones MIC breakpoint Disk Zone diameter Notes

Aminoglycosides1 MIC breakpoint Disk Zone diameter Notes

Glycopeptides MIC breakpoint Disk Zone diameter Notes

Tetracyclines MIC breakpoint Disk Zone diameter Notes

Miscellaneous MIC breakpoint Disk Zone diameter Notes

Disk diffusion (EUCAST standardised disk diffusion method)

Antibiotic agent MIC breakpoint Disk Zone diameter Notes

Disk diffusion (EUCAST standardised disk diffusion method)

Penicillins1 MIC breakpoint Disk Zone diameter Notes

Mecillinam (uncomplicated UTI only) - - - -

Cephalosporins MIC breakpoint Disk Zone diameter Notes

Carbapenems MIC breakpoint Disk Zone diameter Notes

Monobactams MIC breakpoint Disk Zone diameter Notes

Fluoroquinolones MIC breakpoint Disk Zone diameter Notes

Aminoglycosides1 MIC breakpoint Disk Zone diameter Notes

Glycopeptides MIC breakpoint Disk Zone diameter Notes

Tetracyclines MIC breakpoint Disk Zone diameter Notes

Miscellaneous MIC breakpoint Disk Zone diameter Notes

Disk diffusion (EUCAST standardised disk diffusion method)

Penicillins1 MIC breakpoint Disk Zone diameter Notes

Phenoxymethylpenicillin Note1 Note1 NoteA NoteA

Mecillinam (uncomplicated UTI only) - - - -

Cephalosporins1 MIC breakpoint Disk Zone diameter Notes

Carbapenems1 MIC breakpoint Disk Zone diameter Notes

Monobactams MIC breakpoint Disk Zone diameter Notes

Fluoroquinolones1 MIC breakpoint Disk Zone diameter Notes

Aminoglycosides1 MIC breakpoint Disk Zone diameter Notes

Glycopeptides1 MIC breakpoint Disk Zone diameter Notes

Tetracyclines MIC breakpoint Disk Zone diameter Notes

Miscellaneous MIC breakpoint Disk Zone diameter Notes

Penicillins1 MIC breakpoint Disk Zone diameter Notes

Mecillinam (uncomplicated UTI only) - - - -

Cephalosporins MIC breakpoint Disk Zone diameter Notes

Carbapenems MIC breakpoint Disk Zone diameter Notes

Monobactams MIC breakpoint Disk Zone diameter Notes

Fluoroquinolones MIC breakpoint Disk Zone diameter Notes

Aminoglycosides1 MIC breakpoint Disk Zone diameter Notes

Glycopeptides MIC breakpoint Disk Zone diameter Notes

Tetracyclines MIC breakpoint Disk Zone diameter Notes

Miscellaneous MIC breakpoint Disk Zone diameter Notes