In vitro susceptibility testing versus in vivo effectiveness.
The clinical relevance of susceptibility testing has always been questioned because of the difficulty of correlating in vitro susceptibility testing with in vivo clinical effectiveness. Clearly there have always been host/pathogen factors that influence the clinical outcome that cannot be predicted by the results of susceptibility testing. However, improved understanding of pharmacodynamic and pharmacokinetic parameters has greatly improved the use of antimicrobial agents. Most importantly, the integration of these pharmacodynamic and pharmacokinetic indices has greatly improved the correlation between in vitro susceptibility testing and in vivo clinical effectiveness and allows more realistic breakpoints. Finally, the clinical microbiology laboratory has advanced with improved methods as well as the adaptation of breakpoints that are more realistic.
Stratton
Charles W
CW
Vanderbilt University School of Medicine, 21st and Edgehill Road, Nashville, TN 37232, USA. Charles.Stratton@vanderbilt.edu
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000188:drug therapy; D002986:Clinical Trials as Topic; D006801:Humans; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests / Q000379:methods*; D013211:Staphylococcus aureus / Q000187:drug effects
D000900:Anti-Bacterial Agents