Starting in the 1970s, cephalothin susceptibility testing was used to predict the susceptibility of oral cephalosporins; however, more recent data demonstrated that cefazolin is a more accurate proxy than cephalothin for uncomplicated urinary tract infections (uUTIs) caused by Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis (1–3). As a result, the Clinical Laboratory Standards Institute (CLSI) implemented a urine-specific, cefazolin breakpoint and updated the M100 in 2014 to recommend cefazolin as a surrogate to predict the susceptibility of seven oral cephalosporins: cefaclor, cefdinir, cefpodoxime, cefprozil, cefuroxime, cephalexin, and loracarbef for treatment of uUTIs. This review will focus on cefazolin antimicrobial susceptibility results as a surrogate for predicting oral cephalosporin activity in uUTIs; we consider the use of IV cefazolin breakpoints to be beyond the scope of this review.

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头孢唑林作为指定肠杆菌尿头孢菌素活性的预测因子

从20世纪70年代开始，头孢菌素药敏试验被用来预测口服头孢菌素的药敏情况；然而，最近的数据表明，对于由大肠杆菌、肺炎克雷伯菌和奇异变形杆菌引起的单纯性尿路感染 (uUTI)，头孢唑啉比头孢噻吩更准确 (1-3)。因此，临床实验室标准研究所 (CLSI) 实施了尿液特异性头孢唑啉断点，并于 2014 年更新了 M100，推荐头孢唑林作为替代品来预测七种口服头孢菌素的敏感性：头孢克洛、头孢地尼、头孢泊肟、头孢丙烯、头孢呋辛、头孢氨苄和劳拉卡头用于治疗尿路感染。本综述将重点关注头孢唑林抗菌药物敏感性结果，作为预测 uUTI 中口服头孢菌素活性的替代指标；我们认为静脉注射头孢唑林断点的使用超出了本次审查的范围。