Randomized controlled trial of biofilm antimicrobial susceptibility testing in cystic fibrosis patients

Yvonne C W Yau, Felix Ratjen, Elizabeth Tullis, Pearce Wilcox, Andreas Freitag, Mark Chilvers, Hartmut Grasemann, James Zlosnik, David Speert, Mary Corey, Sanja Stanojevic, Larissa Matukas, Timothy Ronan Leahy, Sarah Shih, Valerie Waters
Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society 2015, 14 (2): 262-6
This study aimed to determine whether antimicrobial susceptibility testing of Pseudomonas aeruginosa grown as a biofilm, rather than planktonically, improves efficacy of antibiotic treatment for pulmonary exacerbations. This was a multicenter randomized, double-blind controlled trial of 14 days of intravenous antibiotic treatment for pulmonary exacerbations chosen based on conventional vs. biofilm antimicrobial susceptibility results in CF patients with chronic P. aeruginosa infection. There were 74 exacerbations in 39 patients. A total of 46% (12/26) exacerbations in the conventional group compared to 40% (19/48) exacerbations in the biofilm group achieved a ≥3 log drop in P. aeruginosa sputum density (difference -0.03, 95% CI -0.5 to 0.4, p=0.9). Lung function improvements were similar in both groups. Biofilm antimicrobial susceptibility testing did not lead to improved microbiological or clinical outcomes compared to conventional methods in the treatment of pulmonary exacerbations in CF patients with chronic P. aeruginosa.

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