RT Journal Article SR Electronic T1 The Bugs Don't Lie JF PDA Journal of Pharmaceutical Science and Technology JO PDA J Pharm Sci Technol FD Parenteral Drug Association (PDA) SP pdajpst.2019.009894 DO 10.5731/pdajpst.2019.009894 A1 Agalloco, James P YR 2019 UL http://journal.pda.org/content/early/2019/09/13/pdajpst.2019.009894.abstract AB Sterilization is a critical process in the preparation of many drug products. Its execution and validation are addressed in numerous regulatory, pharmacopeial and industry documents. EMA Annex 1: Sterile Medicinal Products stands alone in giving clear preference to physical measurements over those obtained from biological indicators. This paper reviews principles behind sterilization processes outlining the differences between physical and biological measurements, as well as their relationship to each other. The assumptions associated with the use of physical measurement are explored and their derivation from microbiological results is traced with the intent of re-affirming the primacy of biological evidence. The arguments and objections to the use of biological indicators in sterilization are reviewed and deconstructed.