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Type: Journal article
Title: MIC-based dose adjustment: facts and fables
Author: Mouton, J.
Muller, A.
Canton, R.
Giske, C.
Kahlmeter, G.
Turnidge, J.
Citation: Journal of Antimicrobial Chemotherapy, 2018; 73(3):564-568
Publisher: Oxford University Press
Issue Date: 2018
ISSN: 0305-7453
Statement of
Johan W. Mouton, Anouk E. Muller, Rafael Canton, Christian G. Giske, Gunnar Kahlmeter and John Turnidge
Abstract: Over recent decades, several publications have described optimization procedures for antibiotic therapy in the individual patient based on antimicrobial MIC values. Most methods include therapeutic drug monitoring and use a single MIC determination plus the relevant pharmacokinetics/pharmacodynamics to adjust the dose to optimize antimicrobial drug exposure and antibacterial effects. However, the use of an MIC obtained by a single MIC determination is inappropriate. First, routine clinical laboratories cannot determine MICs with sufficient accuracy to guide dosage owing to the inherent assay variation in the MIC test. Second, the variation in any MIC determination, whatever method is used, must be accounted for. If dose adjustments are made based on therapeutic drug monitoring and include MIC determinations, MIC variation must be considered to prevent potential underdosing of patients. We present the problems and some approaches that could be used in clinical practice.
Keywords: Humans
Anti-Bacterial Agents
Drug Monitoring
Microbial Sensitivity Tests
Reproducibility of Results
Dose-Response Relationship, Drug
Biological Variation, Population
Rights: © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email:
DOI: 10.1093/jac/dkx427
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