Kowalska-Krochmal Beata, Dudek-Wicher Ruth
Department of Pharmaceutical Microbiology and Parasitology, Faculty of Pharmacy, Medical University of Silesian Piasts in Wroclaw, Borowska 211, 50-556 Wroclaw, Poland.
Pathogens. 2021 Feb 4;10(2):165. doi: 10.3390/pathogens10020165.
Inefficiency of medical therapies used in order to cure patients with bacterial infections requires not only to actively look for new therapeutic strategies but also to carefully select antibiotics based on variety of parameters, including microbiological. Minimal inhibitory concentration (MIC) defines in vitro levels of susceptibility or resistance of specific bacterial strains to applied antibiotic. Reliable assessment of MIC has a significant impact on the choice of a therapeutic strategy, which affects efficiency of an infection therapy. In order to obtain credible MIC, many elements must be considered, such as proper method choice, adherence to labeling rules, and competent interpretation of the results. In this paper, two methods have been discussed: dilution and gradient used for MIC estimation. Factors which affect MIC results along with the interpretation guidelines have been described. Furthermore, opportunities to utilize MIC in clinical practice, with pharmacokinetic /pharmacodynamic parameters taken into consideration, have been investigated. Due to problems related to PK determination in individual patients, statistical estimation of the possibility of achievement of the PK/PD index, based on the Monte Carlo, was discussed. In order to provide comprehensive insights, the possible limitations of MIC, which scientists are aware of, have been outlined.
用于治疗细菌感染患者的医学疗法效率低下,这不仅需要积极寻找新的治疗策略,还需要根据包括微生物学在内的各种参数仔细选择抗生素。最低抑菌浓度(MIC)定义了特定细菌菌株对所用抗生素的体外敏感或耐药水平。对MIC的可靠评估对治疗策略的选择有重大影响,而治疗策略会影响感染治疗的效果。为了获得可靠的MIC,必须考虑许多因素,如正确的方法选择、遵守标记规则以及对结果的正确解读。本文讨论了两种用于估计MIC的方法:稀释法和梯度法。描述了影响MIC结果的因素以及解读指南。此外,还研究了在临床实践中考虑药代动力学/药效学参数来利用MIC的机会。由于个体患者药代动力学测定存在问题,讨论了基于蒙特卡洛法对达到药代动力学/药效学指标可能性的统计估计。为了提供全面的见解,概述了科学家们所意识到的MIC可能存在的局限性。