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Method reference

Minimum inhibitory concentration: the number every antibacterial program lives by

The MIC is the lowest concentration of a compound that stops visible growth of an organism. Everything downstream, from breakpoints to dosing, is anchored to it.

At a glance

Definition
Lowest concentration that stops visible growth
Reference method
Broth microdilution, CLSI and EUCAST
Unit
µg/mL, or mg/L, the same number
Resolution
Doubling dilutions, so plus or minus one step

The minimum inhibitory concentration is the lowest concentration of an antibacterial that prevents visible growth of an organism after a defined incubation. It is the number every antibacterial program lives by, and it hides more convention than most people expect.

The definition, precisely

A MIC is defined against a specific organism, a specific method, a specific inoculum and a specific incubation time. Change any of those and the number moves. The reference method is broth microdilution, standardised by CLSI and by EUCAST, with a starting inoculum of roughly 5 x 105 colony forming units per millilitre and incubation of 16 to 20 hours.

The result is reported in µg/mL, which is numerically identical to mg/L. A MIC of 2 µg/mL means growth was visible at 1 and not at 2.

Why the value is always a power of two

The plate is prepared as a doubling dilution series: 0.03, 0.06, 0.12, 0.25, 0.5, 1, 2, 4, 8 and so on. The MIC is whichever of those wells is the first clear one, so the measurement has the resolution of one doubling dilution and no more. Two competent labs testing the same compound and strain routinely land one step apart, and that is considered agreement rather than error.

This is why Antibacterial predicts a band such as 0.5-2 rather than a single decimal. A predicted 0.73 µg/mL would be false precision applied to a measurement that never had that precision.

How it is measured

  • Broth microdilution. The reference. A 96 well plate, a doubling dilution series in each row, a standardised inoculum, read by eye or by optical density.
  • Agar dilution. Antibacterial incorporated into agar plates at each concentration, organisms spotted on top. Laborious but good for testing many organisms against a few concentrations.
  • Gradient diffusion strips. A strip carrying a concentration gradient laid on an inoculated plate. Fast and convenient, and it can read between the doubling steps, which is convenient rather than more accurate.
  • Disk diffusion. Not a MIC at all. It measures a zone of inhibition in millimetres, which is then interpreted against a species specific table.

Quality control strains with known expected ranges are run alongside, which is how a lab knows the plate itself is behaving. Details of the bench procedure are in the blog post on how MIC is measured.

MIC50, MIC90 and breakpoints

Three related numbers are easily confused:

TermWhat it isWhat it is for
MICThe value for one compound against one isolateBench result
MIC50The concentration inhibiting half of a collection of isolatesDescribing a population
MIC90The concentration inhibiting ninety percent of that collectionThe number quoted in surveillance papers
BreakpointA regulatory threshold separating susceptible from resistantClinical interpretation, set by CLSI or EUCAST

A breakpoint is not a property of the compound. It is a decision that takes the MIC distribution, the achievable drug exposure in a patient and the clinical outcome data into account. That is why the same MIC can be susceptible for one species and resistant for another.

Where MIC data comes from, and why it is hard to use

Published MIC values are scattered across primary literature, surveillance reports and public databases such as ChEMBL. Assembling a picture for one compound means reconciling different methods, different strain collections and different reporting conventions. It is entirely doable and it takes an afternoon per compound, which is the specific cost a screening layer removes.

Predicting a MIC band before the plate

A predicted band is not a measurement and it is not a substitute for one. What it is good for is ordering: deciding which twelve of four hundred analogs justify plate time this month, and knowing in advance which organism is likely to be the one that kills the series. On Gram-negatives that will usually be uptake or efflux rather than affinity, for the reasons set out under Gram-negative bacteria.

Run a compound you already know well through the screen below and compare the band against the literature you already trust. That is the fastest way to calibrate how much weight to put on it.

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Strain panel

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Sample output Ciprofloxacin Fluoroquinolone
Worked example, replaced when you run
Strain MIC (µg/mL) Call Resistance risk Conf.
S. aureus (MRSA) 0.5->32 R Resistant target mutation, grlA and gyrA Fluoroquinolone resistance is widespread in methicillin resistant lineages.
E. coli <=0.015-0.06 S Susceptible efflux, AcrAB-TolC in resistant isolates Potent against wild type; qnr carriage and gyrA changes shift the band sharply.
K. pneumoniae (CRE) 0.5->64 R Resistant gyrA mutation with plasmid qnr Carbapenemase producing isolates almost always carry quinolone resistance too.
A. baumannii 8->64 R Resistant efflux, AdeABC Constitutive efflux plus target changes leave little room at achievable exposure.
P. aeruginosa 0.25-2 I Intermediate efflux, MexAB-OprM Borderline: active on many isolates, lost quickly once efflux is derepressed.
E. faecium (VRE) 4->32 R Resistant target mutation, parC Enterococci are intrinsically poor fluoroquinolone targets.

Why

Ciprofloxacin is a well characterised fluoroquinolone, so the Gram-negative bands are strongly supported by published activity data. The deciding factor across this panel is not target affinity but exposure: efflux in P. aeruginosa and A. baumannii, and acquired target mutation everywhere resistance is already common. Against a modern ESKAPE panel it reads as a Gram-negative agent with two reliable losses.

Closest published analogs

  • Levofloxacin Broadly similar Gram-negative bands, better Gram-positive coverage
  • Delafloxacin Retains activity against many ciprofloxacin resistant staphylococci
Strain MIC (µg/mL) Call Resistance risk Conf.

Why

Closest published analogs

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Computational prediction from published literature. Research use only, not a lab measurement and not clinical guidance.

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