[Why should we measure MIC?].

Abstract

In actual infectious diseases, bacterial invasion and the effect of antibiotics show "dynamic" behavior, being continuously influenced by various factors. Therefore, "some" knowledge and experience are essential to treat a patient and to make an appropriate decision through only limited information. On the other hand, many patients today still die of infection at the terminal state of illness. Therefore, the importance of "clinical microbiology" has not faded away at all, and will increase much more in the future. However, medical students are not well taught "drug-dynamics" and "how to perform empiric therapy" in the under-graduate curriculum. Thus, such knowledge must be obtained by "self-effort"; i.e., why MIC should be measured, how to make use of MIC for treatment, what the most important information upon treatment of infection is, what moiety is not reflected by MIC, how to judge from which point of MICs, and so on. Furthermore, education or guidance in such fields are not always provided even in the post-graduate training course. To solve these difficulties, we originated a new computer system supporting antimicrobial chemotherapy, which has actually been working well in our hospital from May of 1994. This system is intended to convey maximally the "meaning" of the test results, instead of just reporting only "prosaic" results. In this system, detailed information on various kinds of bacteria and antibiotics is immediately available on every computer monitor. Furthermore, the data base on the average concentration of various antibiotics expected to be reached in each organ by every dose method is already in the system. When MIC actually measured is larger or smaller than such a value, a signal of "untreatable" or "treatable" will appear on the monitor. This is an epoch-making system in Japan, and will help the physicians to provide effective therapy.