Journal article
Randomized trial of biofilm testing to select antibiotics for cystic fibrosis airway infection
Pediatric pulmonology, Vol.46(2), pp.184-192
02/2011
DOI: 10.1002/ppul.21350
PMCID: PMC3479399
PMID: 20963843
Abstract
Rationale: In cystic fibrosis (CF), conventional antibiotic susceptibility results correlate poorly with clinical outcomes. We hypothesized that biofilm testing would more accurately reflect the susceptibilities of bacteria infecting CF airways.
Methods: A multicenter randomized pilot trial was conducted to assess the efficacy and safety of using biofilm susceptibility testing of Pseudomonas aeruginosa sputum isolates to guide antibiotic regimens for chronic airway infections in clinically stable adolescent and adult CF patients. Thirty-nine participants were randomized to biofilm or conventional treatment groups; 14-day courses of two antibiotics were selected according to an activity-based algorithm using the corresponding susceptibility results.
Results: Of the agents tested, meropenem was most active against biofilm-grown bacteria, and was included in regimens for about half of each study group. For 19 of 39 randomized participants, randomization to the other study group would not have changed the antibiotic classes of the assigned regimen. Study groups were comparable at baseline, and had similar mean decreases in bacterial density, measured in log(10) colony forming units per gram of sputum (biofilm, -2.94 [SD 2.83] vs. conventional, -3.27 [SD 3.09]), and mean increases in forced expiratory volume in 1 sec, measured in liters (0.18 [SD 0.20] vs. 0.12 [SD 0.22]).
Conclusions: In this pilot study, antibiotic regimens based on biofilm testing did not differ significantly from regimens based on conventional testing in terms of microbiological and clinical responses. The predictive value of biofilm testing may nonetheless warrant evaluation in an adequately powered clinical trial in younger CF patients or those experiencing acute pulmonary exacerbation.
Details
- Title: Subtitle
- Randomized trial of biofilm testing to select antibiotics for cystic fibrosis airway infection
- Creators
- Samuel M Moskowitz - Department of Pediatrics, Massachusetts General Hospital, Boston, MassachusettsJulia C Emerson - Department of Pediatrics, University of Washington School of Medicine, Seattle, WashingtonSharon McNamara - Seattle Children's Hospital, Seattle, WashingtonRichard D Shell - Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OhioDavid M Orenstein - Division of Pulmonary Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PennsylvaniaDaniel Rosenbluth - Departments of Internal Medicine and Pediatrics, Washington University School of Medicine, St. Louis, MissouriMarcia F Katz - Department of Medicine, Baylor College of Medicine, Houston, TexasRichard Ahrens - Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IowaDouglas Hornick - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaPatricia M Joseph - Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OhioRonald L Gibson - Department of Pediatrics, University of Washington School of Medicine, Seattle, WashingtonMoira L Aitken - Department of Medicine, University of Washington School of Medicine, Seattle, WashingtonWade W Benton - Seattle Children's Hospital, Seattle, WashingtonJane L Burns - Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
- Resource Type
- Journal article
- Publication Details
- Pediatric pulmonology, Vol.46(2), pp.184-192
- DOI
- 10.1002/ppul.21350
- PMID
- 20963843
- PMCID
- PMC3479399
- NLM abbreviation
- Pediatr Pulmonol
- ISSN
- 8755-6863
- eISSN
- 1099-0496
- Publisher
- Wiley Subscription Services, Inc., A Wiley Company
- Number of pages
- 9
- Grant note
- DOI: 10.13039/100000897, name: Cystic Fibrosis Foundation; DOI: 10.13039/100000002, name: National Institutes of Health
- Language
- English
- Date published
- 02/2011
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984094756002771
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