What are the Indian guidelines for Antimicrobial Susceptibility Testing (AST) report interpretation?

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Last updated: March 23, 2025View editorial policy

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From the Research

The Indian guidelines for Antimicrobial Susceptibility Test (AST) reporting follow the Clinical and Laboratory Standards Institute (CLSI) guidelines, as most Indian laboratories adhere to these standards 1. The guidelines recommend using the three-category interpretation system of Susceptible (S), Intermediate (I), and Resistant (R) for reporting AST results.

  • For routine testing, laboratories should report results for first-line antibiotics appropriate for the isolated organism and infection site, with second-line agents reported only when resistance to first-line drugs is detected.
  • The guidelines emphasize selective reporting, where only clinically relevant antibiotics for specific pathogens are included in reports.
  • For blood and cerebrospinal fluid isolates, extended panels should be tested and reported.
  • The guidelines also recommend including interpretive comments with AST reports to guide clinicians on appropriate antibiotic selection, dosing, and duration. Additionally, laboratories should follow standardized methods like CLSI or EUCAST (European Committee on Antimicrobial Susceptibility Testing) for testing procedures, with regular quality control measures, as outlined in recent updates to the CLSI performance standards for antimicrobial susceptibility testing 2 and in accordance with EUCAST guidelines for minimum inhibitory concentration (MIC) assays 3. These standardized reporting practices help combat antimicrobial resistance by promoting judicious antibiotic use and ensuring consistent interpretation of susceptibility results across healthcare facilities in India, which is crucial given the growing concern of antimicrobial resistance globally 4 and the need for updated approaches to antimicrobial stewardship through thoughtful antimicrobial susceptibility testing and reporting strategies 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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