ArticleJournal of cystic fibrosis : official journal of the European Cystic Fibrosis Society2019
The use of antimicrobial susceptibility testing in pediatric cystic fibrosis pulmonary exacerbations.
Article in Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed, 16 citations in OpenAlex.
- Pf bacteriophages hinder sputum antibiotic diffusion via electrostatic binding.Science advances · 2024Article
- Pf bacteriophages hinder sputum antibiotic diffusion via electrostatic binding.bioRxiv : the preprint server for biology · 2024Article
- Antibiotic Regimen Changes during Cystic Fibrosis Pediatric Pulmonary Exacerbation Treatment.Annals of the American Thoracic Society · 2023Article
- Can Identifying Pulmonary Exacerbation Phenotypes Guide New Treatment Approaches for Cystic Fibrosis?Annals of the American Thoracic Society · 2022Article
- Pseudomonas aeruginosa antimicrobial susceptibility test (AST) results and pulmonary exacerbation treatment responses in cystic fibrosis.Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2021Article
- Duration of antibiotic therapy in non-cystic fibrosis bronchiectasis.Current pulmonology reports · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAlthough antimicrobial susceptibility testing (AST) frequently guides cystic fibrosis (CF) pulmonary exacerbation (PEx) management, its clinical utility is unclear. This study examined associations between AST and antimicrobial switching during PEx treatment and time and occurrence of next PEx as treatment outcomes.
methodsThis retrospective cohort study utilized Pediatric Health Information System data. Children and adolescents aged 1-18 years admitted for a PEx from 2011 to 2016 were studied. Antimicrobial switching was defined as any intra-admission change in intravenous (IV), oral, and/or inhaled antimicrobials. Time to next PEx was defined as the time between index PEx hospital discharge and subsequent hospital admission requiring IV antimicrobials. Odds of antimicrobial switching ≥5 days after treatment initiation were determined by generalized linear mixed models, and associations between AST and time to next PEx were studied using Kaplan-Meier curves and Cox proportional hazards regression.
resultsAST occurred in 2518 (39%) of 6451 PEx at 36 hospitals and was associated with increased odds of antimicrobial switching (OR 1.33, 95% CI 1.16-1.52; p = 0.001) and increased hazard of future PEx (HR 1.32, 95% CI 1.16-1.50; p < 0.001). However, antimicrobial switching was not associated with a longer time to next PEx.
conclusionsAST was associated with both increased probability of antimicrobial regimen change and increased PEx hazard. There was no evidence that antimicrobial regimen change was associated with clinical benefit as assessed by time to next PEx. However, these results indicate residual indication bias remained after adjustment for available disease covariates. Additional studies of the clinical value of AST are warranted.
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