Interpréter un antibiogramme en pratique clinique à l’hôpital

Abstract

The antibiotic susceptibility test (antibiogram) is an essential tool in the treatment of bacterial infections. By guiding the choice of antibiotic based on bacterial susceptibility, it plays a key role in determining therapeutic success. This practical update is intended for clinicians. It covers the principles of how antibiograms are performed, along with the foundations for interpreting their results. Recent changes in EUCAST categorization (S, SFP, R) are explained, with particular emphasis on the concept of “increased exposure” for antibiotics classified as SFP (Susceptible, Increased exposure). The second part focuses on interpreting the antibiogram in a clinical context, taking into account bacteriological, clinical (site of infection, severity, comorbidities), and pharmacological parameters (PK/PD, antibiotic concentration at the infection site). Practical examples of how to use the minimum inhibitory concentration (MIC) are provided to help guide therapeutic decisions. Finally, the specific features of the most frequently encountered bacteria in both outpatient and hospital settings are discussed. This review aims to strengthen prescribers’ competencies in adopting a rational and individualized approach to antibiotic therapy, in the face of the growing challenge of bacterial resistance.