Evaluation of methods for antibiotic synergy testing to treat multidrug resistant bacterial infections in a clinical laboratory, to aid treatment options

The role of the clinical microbiology laboratory is to provide information regarding the use of antimicrobials for the treatment of infectious diseases. Patients are prescribed multiple antibiotics daily especially those who are bacteraemic, septic or in intensive care and routine laboratory testing does not test for these antibiotic regimens (Doern, 2014). The laboratory is designed to test single bacterial isolates against a range of antibiotics, current methodology for synergy testing is either not suitable for use in a clinical laboratory or there is not enough evidence to support the introduction of synergy testing methodology.

Currently the limitation of the gold standard method TKA is that it is labour intensive and complex. MIC methods and DA are easier to perform but there is not enough evidence to suggest that they correlate with gold standard methods such as TKA. This research project aims to review the simpler methods, add to the current research available and build on the work of other researchers so that hopefully synergy testing in a clinical laboratory will become a routine service rather than research only.

If a reliable method can be identified this has the potential to unlock testing of numerous antibiotic combinations, delivered by a clinical microbiology laboratory, within a time frame that benefits patient care and is clinically useful.