{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T21:44:11Z","timestamp":1775511851815,"version":"3.50.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":84,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002066","name":"GSK","doi-asserted-by":"publisher","award":["207965"],"award-info":[{"award-number":["207965"]}],"id":[{"id":"10.13039\/501100002066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the antibiotic susceptibility of community-acquired respiratory tract infection (CA-RTI) Streptococcus pneumoniae and Haemophilus influenzae isolates from Italy and Spain, 2018\u201321.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MICs were determined by CLSI broth microdilution, and susceptibility data were interpreted using CLSI, EUCAST and pharmacokinetic\/pharmacodynamic (PK\/PD) breakpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 77 S. pneumoniae and 249 H. influenzae were collected from Italy and 176 S. pneumoniae and 275 H. influenzae from Spain. Approximately 65% of pneumococci were penicillin-susceptible by CLSI oral or EUCAST low-dose breakpoints; by EUCAST high-dose or CLSI intravenous administration, 92.2%\/95.5% (Italy\/Spain) were susceptible. In Italy, 71.4% to 89.6% susceptibility (CLSI) was observed to amoxicillin\/clavulanic acid, amoxicillin and most cephalosporins. Cefaclor, tetracyclines, macrolides and trimethoprim\/sulfamethoxazole were less active against Italian (51.9%\u201367.5% susceptible) versus Spanish (67.0%\u201381.2% susceptible) isolates. The most potent antibiotics were fluoroquinolones (\u226599.4%, excluding EUCAST low-dose). Most H. influenzae isolates were \u03b2-lactamase negative with a few ampicillin-resistant isolates (CLSI: 0.5% Italy, 3.1% Spain). Rates of \u03b2-lactamase positivity were 14.1% (Italy) and 17.1% (Spain). Susceptibility was &amp;gt;90% (CLSI) except for ampicillin (82.7% Italy, 81.1% Spain) and trimethoprim\/sulfamethoxazole (71.1% Italy, 68.0% Spain). Susceptibility by EUCAST was similar to CLSI, except for cefuroxime (82.3% Italy, 87.3% Spain susceptible, increased exposure versus 100% by CLSI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Susceptibility of S. pneumoniae to many antibiotics was low in both countries, with susceptibility &amp;gt; 90% observed only with high-dose penicillin and fluoroquinolones (CLSI and EUCAST) and high-dose amoxicillin or amoxicillin\/clavulanic acid (PK\/PD). Higher susceptibility was seen with H. influenzae in both countries. Continued surveillance of antimicrobial resistance is important for guiding therapy of CA-RTIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf283","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T11:52:01Z","timestamp":1753271521000},"page":"iii2-iii18","source":"Crossref","is-referenced-by-count":2,"title":["Results from the Survey of Antibiotic Resistance (SOAR) 2018\u201321 in Italy and Spain: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic\/pharmacodynamic (PK\/PD) breakpoints"],"prefix":"10.1093","volume":"80","author":[{"given":"Didem","family":"Torumkuney","sequence":"first","affiliation":[{"name":"Infectious Disease Research Unit, GSK , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1675-3173","authenticated-orcid":false,"given":"Rafael","family":"Canton","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ramon y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS) , Madrid ,","place":["Spain"]},{"name":"CIBER de Enfermedades Infecciosas (CIBERINFEC) , Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Pitart","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Hospital Clinic, University of Barcelona, ISGLOBAL , Barcelona ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9780-7059","authenticated-orcid":false,"given":"Maurizio","family":"Sanguinetti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. 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