Are antipseudomonal antibiotics really beneficial in acute respiratory exacerbations of XXXX ?

@entity1 @entity82 @entity796 @entity1577
BACKGROUND: Although anti-pseudomonal antibiotics are routinely used in the treatment of acute respiratory exacerbations of @entity82 ( @entity1577 ), the specific efficacy of such treatment remains uncertain, the mechanism of action of these agents is not fully understood, and the role of sputum susceptibility testing in clinical decision making is controversial. AIMS: We investigated the relationship between susceptibility testing and clinical outcome in adult @entity1577 @entity1 colonised with @entity796 . METHODS: Sputum samples were collected before, during and after respiratory exacerbations from 31 admissions (17 @entity1 ). Sputum colony counts and MIC of @entity796 were performed. RESULTS: Sputum colony counts did not change significantly during or after intravenous (IV) antibiotic therapy. Clinical outcome parameters (lung function, 12-minute walking distance, sputum weight and quality of life) were compared with susceptibility of @entity796 colonies isolated at admission to the antibiotics used, and no correlation was evident. There was no evidence for the development of cross-resistance and there was no change in the proportion of mucoid colonies with therapy. CONCLUSIONS: While this study has a small @entity1 sample size, it highlights the inconsistency of the role of antipseudomonal drugs also shown in other similar studies. The presence of @entity796 in sputum of acutely ill @entity1577 @entity1 prompts us to prescribe i.v. antipseudomonal drugs. If this approach was valid, we would expect to find a reduction in sputum colony counts and improvement in clinical parameters with the use of antibiotics to which the organisms were sensitive. The fact that such a relationship cannot be consistently demonstrated in this and other studies suggests that the use of antipseudomonal therapy in these @entity1 requires more critical bacteriological and clinical evaluation.
