ID:IOTS - Infectious Disease Insight Of Two Specialists 58. Mythbusting Cidal vs Static with Microbe Mail
Aug 29, 2023
Guests Jame and Callum discuss the definitions of bactericidal and bacteriostatic antibiotics, the complexities of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), and comparisons of cidal vs static antibiotics in specific clinical scenarios. They challenge the belief that cidal antibiotics are always superior, emphasizing the importance of selecting the most appropriate antibiotic based on pathogens and patients.
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Bactericidal vs. Bacteriostatic Definition
- Bactericidal and bacteriostatic antibiotics are defined by the ratio of minimum bactericidal concentration (MBC) to minimum inhibitory concentration (MIC).
- An MBC/MIC ratio less than four is bactericidal, while a ratio greater than four is bacteriostatic.
Arbitrary Parameters
- James explains that the specific parameters for defining bactericidal and bacteriostatic, like breakpoints, seem arbitrary.
- They appear to be based on historical precedent rather than robust evidence.
Misguided Dogma
- James recounts his experience as a junior doctor, using color-coded mind maps to categorize antibiotics as "good" (bactericidal) or "bad" (bacteriostatic).
- He now recognizes this as flawed dogma leading to poor antibiotic stewardship.