Prescribing practices for intravenous aminoglycosides in UK Cystic Fibrosis clinics: A questionnaire survey

Background: Intravenous aminoglycoside antibiotics are widely used to treat pulmonary infection with Pseudomonas aeruginosa in individuals with cystic fibrosis (CF). Over the last decade evidence has accumulated showing that the choice of aminoglycoside and the dosing regimen may help reduce adverse effects such as nephrotoxicity. 

Methods: We undertook an online survey to determine current practice in UK CF Centres. 

Results: We received a response from 35/48 (73%) centres. A once daily regimen was used in 30/35 (86%) centres. Around one third had stopped using gentamicin in the last 10. years. In most cases respondents reported changing practice in response to new evidence or evidence based guidelines. Obstacles to introducing evidence based practice were identified both at the level of the CF Centre and the hospital trust. 

Conclusions: A once daily aminoglycoside regimen is now used in the majority of UK CF Centres. Tobramycin is first line and many centres have stopped using gentamicin. Obstacles to evidence based practice remain in a minority of centres.