Tuesday, May 8, 2018

Resist Dogma and Question Paradigms! Bacteriostatic vs Bactericidal Antibiotics

I love it when new data emerges that questions dogma and challenges paradigms.

In the book Pandemic, by Sonia Shah, the author explores the danger of paradigms in infectious diseases.Paradigms are theoretical constructs that provide explanatory frameworks for scientific observations. However, paradigms create expectations, which can limit perceptions and result in confirmation bias and change blindness.

This paper, published in Clinical Infectious Diseases, challenges the dogma that bactericidal antibiotics are a better choice than bacteriostatic antibiotics.  The underlying

paradigm is that a 'cidal' antibiotic more effectively kills bacteria and is thus clinically more efficacious.

Not necessarily true.

As masterfully summarized by the authors, a comprehensive review of the literature does not support this conclusion.  Serum and tissue concentrations, along with pharmacodynamics, are likely more important than the bacteriostatic versus bactericidal qualities of the antibiotic.

Resist dogma and question paradigms.

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