Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis

Introduction: Patients with CF experience pulmonary exacerbations. These are often initially empirically treated with intravenous antibiotics, with antibiotic choice refined after susceptibility testing. Methods: We completed a 5-year retrospective review of children attending the Paediatric CF U...

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Main Authors: Hurley, M.N., Amin Ariff, A.H., Bertenshaw, C., Bhatt, J., Smyth, Alan R.
Format: Article
Published: Elsevier 2012
Subjects:
Online Access:https://eprints.nottingham.ac.uk/3174/
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author Hurley, M.N.
Amin Ariff, A.H.
Bertenshaw, C.
Bhatt, J.
Smyth, Alan R.
author_facet Hurley, M.N.
Amin Ariff, A.H.
Bertenshaw, C.
Bhatt, J.
Smyth, Alan R.
author_sort Hurley, M.N.
building Nottingham Research Data Repository
collection Online Access
description Introduction: Patients with CF experience pulmonary exacerbations. These are often initially empirically treated with intravenous antibiotics, with antibiotic choice refined after susceptibility testing. Methods: We completed a 5-year retrospective review of children attending the Paediatric CF Unit, Nottingham. The respiratory sampling, antibiotic prescribing and susceptibility testing guidance were audited. Episodes were classified according to the concordance between the antibiotics prescribed and antibiotic susceptibility testing. Results: Of 52 patients who had previously isolated Pseudomonas aeruginosa, 103 antibiotic courses were commenced that coincided with an isolation of P. aeruginosa. P. aeruginosa was fully susceptible, partially susceptible or fully resistant on 33%, 44.7% or 16.5% of occasions respectively. The antibiotic prescriptions were never changed following antibiotic susceptibility testing. We found no association between change in FEV1 (p = 0.54), change in BMI (p = 0.12) or time to next exacerbation (p = 0.66) and concordance between antibiotic susceptibility and the antibiotics administered. Conclusion: This study contributes to mounting evidence questioning the utility of routine antibiotic susceptibility testing.
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spelling nottingham-31742020-05-04T20:21:34Z https://eprints.nottingham.ac.uk/3174/ Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis Hurley, M.N. Amin Ariff, A.H. Bertenshaw, C. Bhatt, J. Smyth, Alan R. Introduction: Patients with CF experience pulmonary exacerbations. These are often initially empirically treated with intravenous antibiotics, with antibiotic choice refined after susceptibility testing. Methods: We completed a 5-year retrospective review of children attending the Paediatric CF Unit, Nottingham. The respiratory sampling, antibiotic prescribing and susceptibility testing guidance were audited. Episodes were classified according to the concordance between the antibiotics prescribed and antibiotic susceptibility testing. Results: Of 52 patients who had previously isolated Pseudomonas aeruginosa, 103 antibiotic courses were commenced that coincided with an isolation of P. aeruginosa. P. aeruginosa was fully susceptible, partially susceptible or fully resistant on 33%, 44.7% or 16.5% of occasions respectively. The antibiotic prescriptions were never changed following antibiotic susceptibility testing. We found no association between change in FEV1 (p = 0.54), change in BMI (p = 0.12) or time to next exacerbation (p = 0.66) and concordance between antibiotic susceptibility and the antibiotics administered. Conclusion: This study contributes to mounting evidence questioning the utility of routine antibiotic susceptibility testing. Elsevier 2012-07 Article PeerReviewed Hurley, M.N., Amin Ariff, A.H., Bertenshaw, C., Bhatt, J. and Smyth, Alan R. (2012) Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis. Journal of Cystic Fibrosis, 11 (4). pp. 288-292. ISSN 1873-5010 Cystic fibrosis Antibiotic Susceptibility testing Pseudomonas http://www.sciencedirect.com/science/article/pii/S156919931200015X doi:10.1016/j.jcf.2012.02.006 doi:10.1016/j.jcf.2012.02.006
spellingShingle Cystic fibrosis
Antibiotic
Susceptibility testing
Pseudomonas
Hurley, M.N.
Amin Ariff, A.H.
Bertenshaw, C.
Bhatt, J.
Smyth, Alan R.
Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis
title Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis
title_full Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis
title_fullStr Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis
title_full_unstemmed Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis
title_short Results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis
title_sort results of antibiotic susceptibility testing do not influence clinical outcome in children with cystic fibrosis
topic Cystic fibrosis
Antibiotic
Susceptibility testing
Pseudomonas
url https://eprints.nottingham.ac.uk/3174/
https://eprints.nottingham.ac.uk/3174/
https://eprints.nottingham.ac.uk/3174/