Amoxicillin-clavulanate (AMC) is among the most frequently prescribed antibiotics globally. It has broad antibacterial activity against gram-positive, gram-negative, and anaerobic bacteria, and has been utilized to treat infections caused by a broad range of pathogens. AMC breakpoints against Enterobacterales were initially set in the 1980s but since then increases in antibiotic resistance, advances in pharmacokinetic (PK)/pharmacodynamic (PD) analyses, and publication of additional clinical data prompted a reassessment by the Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antimicrobial Susceptibility Testing. Based on this contemporary reappraisal, the CLSI retained the Enterobacterales breakpoints but revised comments regarding dosing associated with use of the AMC breakpoints in the 2022 supplement of M100. This viewpoint provides insight into the CLSI breakpoint reevaluation process and summarizes the data and rationale used to support these revisions to the AMC Enterobacterales breakpoint.

中文翻译：

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阿莫西林克拉维酸针对肠杆菌的断点：临床和实验室标准研究所修订的理由

阿莫西林克拉维酸 (AMC) 是全球最常用的抗生素之一。它对革兰氏阳性菌、革兰氏阴性菌和厌氧菌具有广泛的抗菌活性，并已用于治疗多种病原体引起的感染。针对肠杆菌的 AMC 断点最初于 20 世纪 80 年代设定，但此后抗生素耐药性的增加、药代动力学 (PK)/药效 (PD) 分析的进步以及其他临床数据的发布促使临床和实验室标准研究所 (CLSI) 重新评估抗菌药物敏感性测试小组委员会。基于这一当代重新评估，CLSI 保留了肠杆菌科细菌断点，但修改了有关 2022 年 M100 增刊中使用 AMC 断点相关剂量的评论。该观点提供了对 CLSI 断点重新评估过程的深入了解，并总结了用于支持 AMC 肠杆菌断点修订的数据和基本原理。