Maximizing the productive interface between the clinical microbiologist and the infectious disease clinician

Laboratory testing of antimicrobials is probably the single most important area for close communication between the infectious disease clinician and the clinical microbiologist. The two should work together to determine such basic issues as methods to use for antimicrobial susceptibility testing, agents to test, and format to use for reporting results in both cost-efficient and clinically useful ways. Only a limited number of antimicrobials can be selected from the many new agents. Reporting of results should be structured to promote the use of generally active and less expensive agents while restricting the use of more specialized and more expensive drugs and, at the same time, preventing the rapid emergence of resistance to them. A good working relationship will be especially helpful in determining the applications of minimum bactericidal concentrations, serum bactericidal activity, susceptibility testing of anaerobes, and in selection of methods for detecting resistant isolates of pneumococci, gonococci, and Haemophilus influenzae.