Antimicrobial susceptibility testing and the Clinician.

The clinicians are confronted with infections in their daily practice, and most of the times they rely on national or international data available to treat these infections. Sometimes it works but sometimes organisms do not respond to antimicrobials due to a variety of factors. The data clinician applies is most of the time extrapolated from higher centers, centers of excellence in infectious diseases or he follows guidelines issued by various reputed organizations like WHO, CDC Atlanta, IDSA, NICE, etc. Algorithms followed by the medical fraternity in managing infections have been changing with the advent of automation or computerization. Infectious disease diagnostics and management too has been changing fast since the advent of antibiotics. At the same time, these precious molecules are being used inadvertently due to the lack of isolation of organisms. A few years back clinicians were perplexed with conflicting outcomes of various microbiologic results from different medical centers that used to rely on age-old diagnostics modalities in microbiology. One of the landmarks in modern medicine is the determination of susceptibility of a particular pathogen to select an antimicrobial drug with its adequate blood concentration. In vitro susceptibility of the organism to antibiotics remains a Herculean task. These tests need to properly sampled, stored, incubated, reproduced and accurately performed despite edgy clinician who intends to treat the infection on a war footing. The clinicians are confronted with infections in their daily practice, and most of the times they rely on national or international data available to treat these infections. Sometimes it works but sometimes organisms do not respond to antimicrobials due to a variety of factors. The data clinician applies is most of the time extrapolated from higher centers, centers of excellence in infectious diseases or he follows guidelines issued by various reputed organizations like WHO, CDC Atlanta, IDSA, NICE, etc. Algorithms followed by the medical fraternity in managing infections have been changing with the advent of automation or computerization. Infectious disease diagnostics and management too has been changing fast since the advent of antibiotics. At the same time, these precious molecules are being used inadvertently due to the lack of isolation of organisms. A few years back clinicians were perplexed with conflicting outcomes of various microbiologic results from different medical centers that used to rely on age-old diagnostics modalities in microbiology. One of the landmarks in modern medicine is the determination of susceptibility of a particular pathogen to select an antimicrobial drug with its adequate blood concentration. In vitro susceptibility of the organism to antibiotics remains a Herculean task. These tests need to properly sampled, stored, incubated, reproduced and accurately performed despite edgy clinician who intends to treat the infection on a war footing.