Antibiotic Susceptibility Testing: Present and Future
Antibiotic Susceptibility Testing: Present and Future
AST data remain an essential support to the selection of antimicrobial chemotherapy of bacterial infections. Although assessment of clinical predictability of testing antimicrobial combinations awaits the results of ad hoc clinical studies, recent technological advances may allow a significant reduction of the TTR of AST, and there is an increasing demand for the implementation of these technologies also in the pediatric setting. In fact, because of the relative immaturity of the immune system and the possibility of rapid progression of bacterial infections, the use of rapid AST systems is expected to be of particular interest in this setting.
To maximize efficiency, positioning of rapid AST technologies in the diagnostic workflow must be discussed by clinical microbiologists together with clinical users and the Antimicrobial-Stewardship-Team. Studies designed to quantify the impact of these technologies in clinical and economic outcomes, and to assess their best positioning in the diagnostic workflow (diagnostic stewardship), are still very limited and will be needed. With pediatric patients, in particular, published studies were mostly designed to assess the reliability of rapid AST methods with positive blood cultures, and prospective studies focused on the clinical usefulness of these methods in the pediatric setting are needed.
Concluding Remarks and Practical Recommendations
AST data remain an essential support to the selection of antimicrobial chemotherapy of bacterial infections. Although assessment of clinical predictability of testing antimicrobial combinations awaits the results of ad hoc clinical studies, recent technological advances may allow a significant reduction of the TTR of AST, and there is an increasing demand for the implementation of these technologies also in the pediatric setting. In fact, because of the relative immaturity of the immune system and the possibility of rapid progression of bacterial infections, the use of rapid AST systems is expected to be of particular interest in this setting.
To maximize efficiency, positioning of rapid AST technologies in the diagnostic workflow must be discussed by clinical microbiologists together with clinical users and the Antimicrobial-Stewardship-Team. Studies designed to quantify the impact of these technologies in clinical and economic outcomes, and to assess their best positioning in the diagnostic workflow (diagnostic stewardship), are still very limited and will be needed. With pediatric patients, in particular, published studies were mostly designed to assess the reliability of rapid AST methods with positive blood cultures, and prospective studies focused on the clinical usefulness of these methods in the pediatric setting are needed.
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