EUCAST Breakpoint Tables v16.0 (2026): Interpretation of MICs and Zone Diameters

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EUCAST Breakpoint Tables: Breakpoint tables for interpretation of MICs and zone diameters, Version 16.0 (valid from 2026-01-01).

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About the document

EUCAST has updated the breakpoints for susceptibility testing. Despite the formally “minor” nature of the changes, they may influence the interpretation of susceptibility test results and reporting in individual laboratories.

Note for laboratories: If you do not use the ABioGram system, you will need to update your local interpretation rules and software configurations yourself (e.g., LIS middleware rules, CDS modules, or internal breakpoint tables) to ensure results are interpreted according to the current EUCAST version.

What is being proposed (main changes, but not all)

1) Trimethoprim–sulphamethoxazole (co-trimoxazole) vs Enterobacterales

EUCAST refines the breakpoint approach based on ECOFF considerations and proposes:

• a general breakpoint for Enterobacterales (except Serratia): 0.5/0.5 mg/L and 15/15 mm;;
• a separate line for Serratia spp.: 0.001/2 mg/L and 50/15 mm;
• inclusion of Salmonella spp. under the general Enterobacterales line, since a reliable ECOFF cannot be established due to limited data sources.

Practical impact: reporting rules and LIS/interpretation logic may need a dedicated pathway for Serratia, while Salmonella follows the broader Enterobacterales (except Serratia) entry.

2) Trimethoprim–sulphamethoxazole (co-trimoxazole) vs Staphylococcus spp.

EUCAST refines the breakpoint approach based on ECOFF considerations and proposes:

• a general breakpoint for Staphylococcus spp: 0.5/0.5 mg/L and 24/24 mm;

3) Ampicillin / Amoxicillin (i.v.) vs Streptococcus pneumoniae (meningitis and endocarditis)

EUCAST proposes changing the breakpoints (for i.v. formulations) in meningitis and endocarditis from 0.5/0.5 mg/L to 0.06/0.06 mg/L. The new values are based on the ECOFF and better separate isolates with vs without resistance mechanisms.

Practical impact: some isolates may be re-categorized in these clinical scenarios–consider pre-assessing the effect on local datasets and automated validation rules.

What labs can do in advance

• Review LIS/CDS configuration (species/group logic; a separate rule set for Serratia).
• Assess impact on historical data (potential re-categorization for key organism–drug pairs).
• Update SOPs and training materials, especially for S. pneumoniae in meningitis/endocarditis workflows.

How to cite

The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 16.0, 2026. https://www.eucast.org.

Source

Official EUCAST website: eucast.org