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Cited by 307Cystic Fibrosis Research AdvancesBacterial biofilms and quorum sensingAntibiotics Pharmacokinetics and Efficacy

Susceptibility Testing of Pseudomonas aeruginosa Isolates and Clinical Response to Parenteral Antibiotic Administration

Smith, Arnold L., Fiel, Stanley B., Mayer-Hamblett, Nicole, Ramsey, Bonnie, Burns, Jane L.·2003·Chest
DOI 10.1378/chest.123.5.1495
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Abstract

Study objective To determine the relationship between the antibiotic susceptibility of Pseudomonas aeruginosa isolated from the sputum of patients with cystic fibrosis (CF) and the patient's response to parenteral antibiotic administration, we performed a retrospective analysis using data from patients in the placebo arm of a phase 3 trial of tobramycin solution for inhalation. All patients were chronically infected with P aeruginosa. Seventy-seven of the 262 patients receiving placebo experienced a pulmonary exacerbation during the trial for which they received therapy with IV tobramycin and ceftazidime. The susceptibility of the P aeruginosa isolates to ceftazidime and tobramycin was determined at trial enrollment by broth microdilution.Design The clinical response to combination antibiotic therapy was assessed by analyzing differences in spirometry before and after antibiotic administration. The FEV(1) percent predicted at the first visit after the conclusion of antibiotic administration was compared to the FEV(1) percent predicted prior to antibiotic therapy. The results were analyzed both descriptively and by regression analyses.Results The conditions of 54 patients improved, and those of 9 patients worsened, and in 14 patients there was no change in FEV(1) with antibiotic administration. No correlation was observed between the susceptibility of P aeruginosa to tobramycin or ceftazidime and clinical response. Only the three following variables were observed to significantly correlate with FEV(1) after antibiotic treatment on regression analysis: FEV(1) prior to treatment (p < 0.0001); number of days elapsed between the previous FEV(1) measurement and the initiation of IV antibiotic therapy (p < 0.002); and the number of days elapsed between the determination of the minimum inhibitory concentration and the initiation of IV therapy (p < 0.03). No significant trends were observed between the antibiotic susceptibility of P aeruginosa isolates and treatment outcomes.Conclusion While lack of statistical significance for a trend between bacterial susceptibilities and the response to parenteral antibiotic administration does not mean that no such trend exists, the precision of the confidence intervals allows us to conclude that even if isolate antibiotic susceptibilities affect outcome, the impact would be small and not clinically relevant.

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  • There is no detectable relation between antibiotic susceptibility of cultured organisms and clinical response to therapy in exacerbations, even in cystic fibrosis.

    “there is no detectable relation between antibiotic susceptibility of cultured organisms and clinical response to therapy in exacerbations, even in cystic fibrosis.”

    From The microbiome and critical illness (2016) · cites this paper as [141]

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Authors
Smith, A. L., Fiel, S. B., Mayer-Hamblett, N., Ramsey, B., & Burns, J. L.
Affiliations
  • Center for Infectious Disease Research (US)
  • Hahnemann University Hospital (US)
  • Seattle Children's Hospital (US)
Corresponding author
Smith, Arnold L.
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2003-05
Volume
123
Issue
5
Pages
1495-1502
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.123.5.1495
OpenAlex
W2103884572
Cited by
307
References
19
Citations by year
2026: 5 · 2025: 4 · 2024: 7 · 2023: 10 · 2022: 13 · 2021: 17 · 2020: 14 · 2019: 13 · 2018: 21 · 2017: 20 · 2016: 16 · 2015: 20 · 2014: 17 · 2013: 11 · 2012: 15
FWCI
8.64
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
  • Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
Keywords
Pseudomonas aeruginosa, cystic fibrosis, antibiotic susceptibility, tobramycin, ceftazidime, parenteral antibiotics, pulmonary exacerbations, FEV1, minimum inhibitory concentration, chronic lung infection, treatment response
MeSH terms
Anti-Bacterial Agents, Ceftazidime, Cystic Fibrosis, Drug Therapy, Combination, Forced Expiratory Volume, Humans, Injections, Intravenous, Microbial Sensitivity Tests, Pseudomonas aeruginosa, Pseudomonas Infections, Retrospective Studies, Sputum, Tobramycin, Randomized Controlled Trials as Topic, Drug Resistance, Bacterial

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