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I am unclear of the method you are using for penicillin and cephalosporins. If disk diffusion, this method is unreliable for S. pneumoniae and there are no CLSI disk diffusion breakpoints for these drugs in CLSI M100-S17. Consequently, only the result from oxacillin is valid. If the oxacillin is <=19 mm, the isolate is probably not susceptible to penicillin. However, rare isolates may give a zone slightly below 19 mm but still have a penicillin susceptible MIC. If the isolate were from a sterile source, you should send it out for an MIC ASAP for penicillin and cefotaxime or ceftriaxone. The MDs need these results quickly (particularly for CSF isolates) to properly manage the patient. From other sources, some may report as "non-susceptible" to penicillin.
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