Efficacy ratio: A tool to enhance optimal antimicrobial use for intra‑abdominal infections
By: Sabu, Priyanka
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Contributor(s): Elangovan, Divyaa | Pragasam, Agila Kumari.
Publisher: Mumbai Wolter Kluwer 2018Edition: Vol. 50(6), November-December.Description: 332-335p.Subject(s): PHARMACOLOGY | Antimicrobials | Efficacy ratio | Ertapenem | Gram‑negative organisms | Minimum inhibitory concentrationOnline resources: Click here
In:
Indian Journal of PharmacologySummary: BACKGROUND: Antimicrobial resistance and inappropriate antibiotic regimen hamper a favorable outcome in intra‑abdominal infections. Clinicians rely on the minimum inhibitory concentration (MIC) value to choose from the susceptible antimicrobials. However, the MIC values cannot be directly compared between the different antibiotics because their breakpoints are different. For that reason, efficacy ratio (ER), a ratio of susceptible MIC breakpoint and MIC of isolate, can be used to choose the most appropriate antimicrobial.MATERIALS AND METHODS: A prospective, observational study conducted during 2015 and 2016 included 356 Escherichiacoli and 158 Klebsiella spp. isolates obtained from the intra‑abdominal specimens. MIC was determined by microbroth dilution method, and ER of each antibiotic was calculated for all the isolates.RESULTS: For both E. coli and Klebsiella spp., ertapenem, amikacin, and piperacillin/tazobactam had the best activities among their respective antibiotic classes.DISCUSSION: This is the first study calculating ER for deciding empiric treatment choices. ER also has a potential additional value in choosing the use of susceptible drugs as monotherapy or combination therapy. A shift in ERs over a period of time tracks rising MIC values and predicts antimicrobial resistance development.CONCLUSION: Estimation of ER could be a meaningful addition for the interpretation of an antimicrobial susceptibility report, thus helping the physician to choose the best among susceptible antimicrobials for patient manageme
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School of Pharmacy Archieval Section | Not for loan | 2018286 |
BACKGROUND: Antimicrobial resistance and inappropriate antibiotic regimen hamper a favorable outcome in intra‑abdominal infections. Clinicians rely on the minimum inhibitory concentration (MIC) value to choose from the susceptible antimicrobials. However, the MIC values cannot be directly compared between the different antibiotics because their breakpoints are different. For that reason, efficacy ratio (ER), a ratio of susceptible MIC breakpoint and MIC of isolate, can be used to choose the most appropriate antimicrobial.MATERIALS AND METHODS: A prospective, observational study conducted during 2015 and 2016 included 356 Escherichiacoli and 158 Klebsiella spp. isolates obtained from the intra‑abdominal specimens. MIC was determined by microbroth dilution method, and ER of each antibiotic was calculated for all the isolates.RESULTS: For both E. coli and Klebsiella spp., ertapenem, amikacin, and piperacillin/tazobactam had the best activities among their respective antibiotic classes.DISCUSSION: This is the first study calculating ER for deciding empiric treatment choices. ER also has a potential additional value in choosing the use of susceptible drugs as monotherapy or combination therapy. A shift in ERs over a period of time tracks rising MIC values and predicts antimicrobial resistance development.CONCLUSION: Estimation of ER could be a meaningful addition for the interpretation of an antimicrobial susceptibility report, thus helping the physician to choose the best among susceptible antimicrobials for patient manageme
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