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Measurement of Antibiotic Efficacy – Beyond the MIC

Summary The minimum inhibitory concentration (MIC) has been accepted for many years as the ‘gold standard’ for measuring the activity of an antibiotic against a given bacterium. However, other factors also influence the activity of the antibiotic, including its pharmacokinetics and pharmacodynamics. In addition to the standard method of determining the MIC, there are other ways of sensitivity testing including agar diffusion, broth dilution and the E test. Measurement of bactericidal activity by kill-curves can be extremely useful in predicting clinical response to an antibiotic. Studies with cefaclor suggest that the MIC does not necessarily predict its efficacy in the treatment of respiratory tract infections and that the breakpoint for cefaclor for pneumococci should be equal to or less than 2 mg/L.