Most Active Antibiotic

A was seen in clinic and diagnosed with uncomplicated cystitis. A urine culture is now growing E. coli with the following susceptibility:

Nitrofurantoin=S MIC <32
Cephalexin=S MIC <2
Ciprofloxacin=S MIC <1

Which antibiotic is the MOST active?

A. Nitrofurantoin
B. Cephalexin
C. Ciprofloxacin
D. This is a trick question

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Best Answer

This is a trick question

Explanation: Rather than choosing the drug with the lowest MIC, clinicians should use these factors to pick the best therapy:
-efficacy 💪
-side effects & C. difficile risk 💩
-site of infection 👤
-patient co-morbidities
-logistics e.g. frequency & cost 💲
-most narrow spectrum 🤏

Say it with us: DON’T 👀 FOR THE LOWEST MIC! There are lots of things to consider when selecting the right antibiotic but this is not one of them ❌