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Antimicrobial susceptibility testing: are we wasting our time?
1Department of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, England, UK.
British Journal of Biomedical Science
|March 1, 1993
Summary
Routine bacterial susceptibility testing offers benefits but often doesn't impact patient care. Periodic resistance surveys may be more valuable than routine individual testing for most cases.
Area of Science:
- Medical Microbiology
- Clinical Diagnostics
Background:
- Routine bacterial susceptibility testing is a core function of diagnostic microbiology laboratories.
- There are ongoing debates regarding the value and necessity of routine susceptibility testing.
Purpose of the Study:
- To critically evaluate the arguments for and against routine bacterial susceptibility testing.
- To reassess the role and provision of susceptibility testing services by microbiology laboratories.
Main Methods:
- Review of current practices and clinical utility of bacterial susceptibility testing.
- Analysis of the impact of testing on patient management and antibiotic prescribing.
Main Results:
- Much routine testing provides little direct benefit to patient management as treatments are often initiated before results are available.
- Despite limited direct clinical impact, prescribers continue to demand the service, and epidemiological data are valuable.
- Current laboratory-clinician relationships necessitate a re-evaluation of susceptibility testing services.
Conclusions:
- Routine susceptibility testing may not be essential for all patients, with significant benefits potentially retained through periodic resistance prevalence surveys.
- Individualized testing should be reserved for critically ill patients or those with complex management challenges.
- Microbiologists must adapt their services to evolving clinical needs and optimize the use of laboratory resources.