Multicenter collaborative evaluation of a standardized serum bactericidal test as a predictor of therapeutic efficacy in acute and chronic osteomyelitis

Weinstein, Melvin P.; Stratton, Charles W.; Hawley, H. Bradford; Ackley, Alexander; Reller, L. Barth

doi:10.1016/0002-9343(87)90688-7

Cited by 102 publications

(29 citation statements)

References 21 publications

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“…The SBT integrates both pharmacokinetic and pharmacodynamic properties in a single set of determinations that examines the ability of the patient's serum, drawn at various times during the dosing interval, usually at the beginning and end of the administered antimicrobial agent, to kill the infecting organism (7,22,69,74,76,77,86,87). This can be done using dilution methodology to determine the maximum dilution or "titer" of the patient's serum which demonstrates 99.9% killing of the final inoculum (serum bactericidal titer).…”

Section: Standardized Methodsmentioning

confidence: 99%

“…Alternatively, a time-kill method may be used to determine the rate of killing of the infecting organism (change in CFU per milliliter per hour of exposure) produced by exposure to a 1:2 dilution of the patient's serum obtained at the beginning (peak) and end (trough) of the dosing interval (7). As with time-kill and MBC determinations, the SBT is affected by methodological variables and has the additional complications of the need to properly collect timed serum specimens (7,22,52,69,76,86,87). Interpretation of test results is also problematic, and the clinical role of the SBT is controversial at best (52,69,76,86,87).…”

Section: Standardized Methodsmentioning

confidence: 99%

“…As with time-kill and MBC determinations, the SBT is affected by methodological variables and has the additional complications of the need to properly collect timed serum specimens (7,22,52,69,76,86,87). Interpretation of test results is also problematic, and the clinical role of the SBT is controversial at best (52,69,76,86,87). The number of clinical situations in which the test may be useful is limited (e.g., endocarditis, osteomyelitis, and septic arthritis); however, it has been valuable in the research setting and in the evaluation of new antimicrobial agents.…”

Section: Standardized Methodsmentioning

confidence: 99%

“…Given the fact that bactericidal activity is considered necessary for proper treatment of certain infections, numerous investigators have VOL. 17, 2004 FUNGICIDAL ACTIVITIES AGAINST YEASTS AND MOLDS 271 used bactericidal testing (MBC, time-kill, and SBT) in efforts to correlate in vitro data with in vivo treatment results (7,12,14,23,38,51,61,68,74,86,87). Unfortunately, the criterion used to define bactericidal activity (99.9% killing of the final inoculum) is completely arbitrary and results in an all-or-nothing situation that probably has no biological or clinical significance (52,53).…”

Section: In Vivo Correlates Of Bactericidal Testingmentioning

confidence: 99%

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Determination of Fungicidal Activities against Yeasts and Molds: Lessons Learned from Bactericidal Testing and the Need for Standardization

2004

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In certain unique clinical settings, the ability of the antimicrobial agent administered to kill the pathogen outright may be quite important. These situations invariably involve infection of a site not easily accessed by host defenses and/or of a structure with essential anatomic or physiologic function such as the heart (endocarditis), central nervous system (meningitis), or bone (osteomyelitis). Likewise, infections in immunosuppressed hosts, especially those who are neutropenic, are often thought to require microbicidal therapy. Proof of the cidal nature of an antimicrobial agent in vitro is tedious, complex, and fraught with error. Although several methods for assessing in vitro bactericidal activity have been standardized (NCCLS M26-A and M21-A), the clinical relevance of these determinations is questionable and the tests are performed infrequently in most laboratories. Most of the clinical data supporting the need for microbicidal therapy and testing have focused on bacterial infections. However, given the fact that most serious fungal infections occur in profoundly immunosuppressed individuals, it is generally assumed that a cidal regimen would be preferable in that setting as well. In view of this clinical concern and the perceived need to assess the fungicidal activity of a variety of agents, we considered that it would be useful to review what is known about the issues and problems in assessing bactericidal activity and the clinical utility of such measurements. Following this review, we discuss the issue of how one defines fungicidal activity in vitro and in vivo and how feasible it might be to determine the fungicidal activity of organism-drug combinations for purposes of both drug development and clinical care. Proposed methods for fungal time-kill determinations and minimal fungicidal concentration determinations are also discussed

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Section: Standardized Methodsmentioning

confidence: 99%

Section: Standardized Methodsmentioning

confidence: 99%

Section: Standardized Methodsmentioning

confidence: 99%

Section: In Vivo Correlates Of Bactericidal Testingmentioning

confidence: 99%

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Determination of Fungicidal Activities against Yeasts and Molds: Lessons Learned from Bactericidal Testing and the Need for Standardization

2004

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“…The studies presented here suggest that MX-2401 exhibited a better bactericidal profile than vancomycin, killing more rapidly and demonstrating bactericidal activity against E. faecalis. Bactericidal activity is important in antimicrobial chemotherapy especially in cases of endocarditis (14) and osteomyelitis (31), as well as for the treatment of the immunocompromised patients (27), where the immune system of the host is unlikely to assist in bacterial eradication. Other observed microbiological properties of MX-2401 include the low frequency of spontaneous resistance, the low potential for emergence of resistance, and a long in vitro PAE, consistent with bacterial cell damage during exposure that impacts the growth fitness of bacteria.…”

mentioning

confidence: 99%

Antimicrobial Properties of MX-2401, an Expanded-Spectrum Lipopeptide Active in the Presence of Lung Surfactant

Dugourd¹,

Yang

Elliott

et al. 2011

Antimicrob Agents Chemother

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Cost Effectiveness of Once‐Daily Oral Antimicrobial Therapy

Davey

Parker

1992

The Journal of Clinical Pharma

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Once daily dosing of oral antimicrobials achieves significantly better patient compliance than three or four times daily dosing, and limited data suggest that this is associated with greater efficacy. Comparison of once daily and twice daily dosing is less consistent, and most studies show only marginally better compliance with once daily dosing versus twice daily dosing. Detection of urinary antimicrobial activity provides a simple method for checking compliance with oral antimicrobials and deserves wider study. Counts of residual tablets have been shown to overestimate compliance. Intravenous formulations are always more expensive than equivalent oral formulations, and preparation and administration of intravenous drugs adds significant additional costs. Moreover, intravenous regimens are complex, and a number of studies have shown that serious errors occur in both preparation and administration of intravenous drugs. There is increasing evidence that serious infections can be adequately treated with oral drugs, and the excellent bioavailability of quinolones makes them particularly attractive for these indications. Clinicians require a method for checking absorption by patients with severe infection, and the Serum Bactericidal Test may provide a practical method for monitoring a wide variety of drugs.

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Multicenter collaborative evaluation of a standardized serum bactericidal test as a predictor of therapeutic efficacy in acute and chronic osteomyelitis

Cited by 102 publications

References 21 publications

Determination of Fungicidal Activities against Yeasts and Molds: Lessons Learned from Bactericidal Testing and the Need for Standardization

Determination of Fungicidal Activities against Yeasts and Molds: Lessons Learned from Bactericidal Testing and the Need for Standardization

Antimicrobial Properties of MX-2401, an Expanded-Spectrum Lipopeptide Active in the Presence of Lung Surfactant

Cost Effectiveness of Once‐Daily Oral Antimicrobial Therapy

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