Open AccessMinimum inhibitory concentration-guided antimicrobial therapy – the Achilles heel in the antimicrobial stewardship agenda
Author(s) -
Warren Lowman
Publication year - 2018
Publication title -
samj. south african medical journal/south african medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.527
H-Index - 57
eISSN - 2078-5135
pISSN - 0256-9574
DOI - 10.7196/samj.2018.v108i9.13285
Subject(s) - antimicrobial , antimicrobial stewardship , medicine , minimum inhibitory concentration , intensive care medicine , drug resistance , antibiotic resistance , selection (genetic algorithm) , drug , pharmacology , antibiotics , microbiology and biotechnology , artificial intelligence , biology , computer science
The global problem of resistance to antimicrobials has resulted in a co-ordinated drive to use antimicrobial agents more responsibly. At a clinical level this is promoted through antimicrobial stewardship which demands appropriate use through optimal drug selection. Many factors play a role in this process of selection, antimicrobial susceptibility and the pharmacodynamics of the drug being two key determinants. Yet the detail provided by current diagnostic antimicrobial susceptibility testing is suboptimal and does not allow for adequate dose optimisation. The minimum inhibitory concentration (MIC) which underlies all antimicrobial susceptibility testing is largely ignored in the decision-making process of optimal drug selection. Understanding and application of MIC-guided antimicrobial therapy is desperately needed if antimicrobial stewardship is to truly fulfil its mandate.