{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T15:29:26Z","timestamp":1781018966112,"version":"3.54.1"},"reference-count":21,"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 Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2018\u201321 from Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MICs were determined by CLSI broth microdilution; 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>S. pneumoniae (n = 57) and H. influenzae (n = 67) were collected from the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. The proportion of penicillin-susceptible pneumococci was 28.1% by CLSI oral\/EUCAST low-dose breakpoints; 98.3%\/98.2% were susceptible by EUCAST high-dose\/CLSI intravenous breakpoints. Good activity (\u226593.0%) was observed using CLSI or PK\/PD breakpoints for amoxicillin, amoxicillin\/clavulanic acid, cefotaxime, cefpodoxime, ceftriaxone, cefuroxime, levofloxacin and moxifloxacin. Cefdinir and cefaclor were less active (75.4% and 57.9%, respectively, by CLSI and 61.4% and 19.3%, respectively, by PK\/PD). Tetracyclines, macrolides and trimethoprim\/sulfamethoxazole were poorly active (5.3%\u201336.8%). EUCAST high-dose breakpoints indicated similar activity, although susceptibility to cefaclor (0%), cefpodoxime (70.2%) and cefuroxime (68.4%) was lower than by CLSI. Most H. influenzae isolates were \u03b2-lactamase negative (95.5%). Generally, antibiotic susceptibility was &amp;gt;83.6% by CLSI for all antibiotics except trimethoprim\/sulfamethoxazole (13.4%). Susceptibility by EUCAST was similar, except for cefuroxime (oral), with 0% susceptible isolates versus 95.5% by CLSI and 67.2% by PK\/PD, fluoroquinolones and macrolides (no EUCAST breakpoint). Macrolide susceptibility by PK\/PD breakpoints was low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although antimicrobial resistance was observed, many therapeutic options remain to treat S. pneumoniae and H. influenzae from CA-RTI in Pakistan despite concerns about high levels of inappropriate antibiotic use. Continued surveillance of antibiotic susceptibility is important for guiding empiric therapy of CA-RTIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf288","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T11:50:32Z","timestamp":1753271432000},"page":"iii83-iii97","source":"Crossref","is-referenced-by-count":1,"title":["Results from the Survey of Antibiotic Resistance (SOAR) 2018\u201321 in Pakistan: 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 Diseases Research Unit, GSK , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9725-3685","authenticated-orcid":false,"given":"Summiya","family":"Nizamuddin","sequence":"additional","affiliation":[{"name":"Department of 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