The rationale behind the IMMUNOBIOGRAM® (IMBG) resembles the one of an antibiogram, a pharmacodynamic in vitro bioassay which evaluate the usefulness of different antibiotics to treat a specific infection in a patient. Antibiogram is used extensively in clinical practice, as it is a very valuable tool in guiding antimicrobial therapy for each patient. It provides the profile of susceptibility or resistance patterns of pathogens to antimicrobials commonly used. Even though some antibiotics can have synergistic actions, this synergy can take place at different levels: it can be related with their mechanisms of action, with their pharmacokinetic and pharmacodynamic issues like cytochrome P450 isoenzyme liver metabolism, with their route of elimination and with other factos. Therefore, it is not possible to predict their whole synergistic potential only based on the analysis of their combination in vitro.
An antibiogram does not test the combination of antibiotics. Final antibiotic selection is decided by taking into account the pathogen susceptibility to each antibiotic from the antibiogram and selecting those with a better potential combination in clinical practice.
A concomitant evaluation of pharmacodynamics and pharmacokinetics of the drugs can be an advisable tool to perform successful patient-tailored immunosuppressive therapy.
Even so, as it is possible to study in vitro the effect of IS combinations with the IMBG, combinations of them will be tested in a further step as a complementary information.