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Chapter 5.15 : Serum Inhibitory and Bactericidal Titers

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Serum Inhibitory and Bactericidal Titers, Page 1 of 2

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Abstract:

Schlichter and MacLean first used serum inhibitory titers (SIT) to assess the effectiveness of penicillin in the treatment of subacute bacterial endocarditis ( ). Other recognized clinical indications for obtaining serum bactericidal titers (SBT) to monitor effective therapy are osteomyelitis, closed-space infections such as meningitis or joint infection, and the use of oral antimicrobial agents after intravenous therapy. Controversy surrounds and will continue to surround the methodology, and there are few clinical situations in which the test is indicated.

Citation: Leber A. 2016. Serum Inhibitory and Bactericidal Titers, p 5.15.1-5.15.16. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.15
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Serum Inhibitory and Bactericidal Titer Worksheet

Serum Inhibitory and Bactericidal Titer Worksheet

Citation: Leber A. 2016. Serum Inhibitory and Bactericidal Titers, p 5.15.1-5.15.16. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.15
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References

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1. Schlichter JG, MacLean H. 1947. A method for determining the effective therapeutic level in the treatment of subacute bacterial endocarditis with penicillin: a preliminary report. Am Heart J 34:209211.
2. NCCLS. 1999. Methodology for the Serum Bactericidal Test. Approved guideline M21-A. NCCLS, Wayne, PA.
3. Weinstein MP, Stratton CW, Ackley A, Hawley HB, Robinson PA, Fisher BD, Alcid DV, Stephens DS, Reller LB. 1985. Multicenter collaborative evaluation of a standardized serum bactericidal test as a prognostic indicator in infective endocarditis. Am J Med 78:262269.
4. Weinstein MP, Stratton CW, Hawley HB, Ackley A, Reller LB. 1987. Multicenter collaborative evaluation of a standardized serum bactericidal test as a predictor of therapeutic efficacy in acute and chronic osteomyelitis. Am J Med 83:218222.
5. Hindler JF, Griffin J. 2010. Serum inhibitory and bactericidal titers. In Garcia LS (ed), Clinical Microbiology Procedures Handbook, 3 ed. ASM Press, Washington, DC.
6. Amsterdam D. 1996. Susceptibility testing of antimicrobials in liquid media, p 103–105. In Lorian V (ed), Antibiotics in Laboratory Medicine, 4th ed. The Williams & Wilkins Co, Baltimore, MD.
7. Araj GF. 2000. Available laboratory tests to guide antimicrobial therapy. J Med Liban 48:199202.
8. Cappelletti DM, Rybak MJ. 1996. Comparison of methodologies for synergism testing of drug combinations against resistant strains of Pseudomonas aeruginosa. Antimicrob Agents Chemother 40:677683.
9. Leggett JE, Wolz SA, Craig WA. 1989. Use of serum ultrafiltrate in the serum bactericidal test. J Infect Dis 160:616623.
10. Matsumura S, Simor AE. 1998. Treatment of endocarditis due to vancomycin-resistant Enterococcus faecium with quinupristin/dalfopristin, doxycycline, and rifampin: a synergistic drug combination. Clin Infect Dis 27:15541556.
11. Reller LB. 1986. The serum bactericidal test. Rev Infect Dis 8:803808.
12. Schwartz BS, Ngo PD, Guglielmo BJ. 2008. Daptomycin treatment failure for vancomycin-resistant Enterococcus faecium infective endocarditis: impact of protein binding? Ann Pharmacother 42:289290.
13. Stratton CW. 1988. Serum bactericidal test. Clin Microbiol Rev 1:1926.
14. Swenson JM, Patel JB, Jorgensen JH. 2011. Special phenotypic methods for detecting antibacterial resistance, p 1155–1179. In Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW (ed), Manual of Clinical Microbiology, 10th ed. ASM Press, Washington, DC.
15. Taylor PC, Schoenknecht FD, Sherris JC, Linner EC. 1983. Determination of minimal bactericidal concentration of oxacillin for Staphylococcus aureus: influence and significance of technical factors. Antimicrob Agents Chemother 23:142150.
1. Schlichter JG, MacLean H. 1947. A method for determining the effective therapeutic level in the treatment of subacute bacterial endocarditis with penicillin: a preliminary report. Am Heart J 34:209211.

Tables

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Untitled

Citation: Leber A. 2016. Serum Inhibitory and Bactericidal Titers, p 5.15.1-5.15.16. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.15
Generic image for table
SIT and SBT test conditions and media for various bacteriaa

SIT and SBT test conditions and media for various bacteria

Citation: Leber A. 2016. Serum Inhibitory and Bactericidal Titers, p 5.15.1-5.15.16. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.15
Generic image for table
Rejection value and calculated sensitivity and specificity for each initial concentration based on duplicate 0.01-ml samplesa

Rejection value and calculated sensitivity and specificity for each initial concentration based on duplicate 0.01-ml samples

Citation: Leber A. 2016. Serum Inhibitory and Bactericidal Titers, p 5.15.1-5.15.16. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.15

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