The logic behind the IMMUNOBIOGRAM® is the one of an antibiogram. A pharmacodynamic in vitro bioassay which evaluates the utility of different antibiotics to treat a specific infection in a patient. Antibiograms are used extensively in clinical practice, as 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 effects, this synergy can take place at different levels. It can be related with their mechanism of action, pharmacokinetic and pharmacodynamic issues (cytochrome P450), isoenzyme liver metabolism, route of elimination, and others. Therefore, it is not possible to predict their whole synergistic potential based on the analysis of their in vitro combination only.
An antibiogram does not test the combination of antibiotics. Final antibiotic selection takes into account the pathogen susceptibility to each antibiotic from the antibiogram, and those with a better potential combination in clinical practice are selected.
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 the in vitro effect of IMSs combinations with the IMMUNOBIOGRAM®, usual combinations of them will be tested in the future as a complementary information.