Described by the World Health Organization as 'one of the biggest threats to global health, food security and development today’, antibiotic resistance occurs when bacteria change and become resistant to antibiotic medication, making it harder to treat the health problems that bacteria and fungi can cause.

 

Appropriate antibiotic usage needs stewardship to prevent global problems

 

With the number of deaths linked to antibiotic resistance set to rise to epidemic proportions worldwide if significant action isn’t taken now, antimicrobial stewardship programmes (ASP) - plans of action that involve preventing infections and instigating antibiotic controls - are now vital in all healthcare settings.

“With approximately 20% of UK antibiotic prescriptions currently thought to be unnecessary1, improvements in the accuracy and speed of diagnosis when a patient is admitted to hospital can play a huge part in controlling the use of antibiotic medication,” says Dr Whitfield.

 

Earlier, more accurate detection will help identify which antibiotics are needed

 

Innovative, rapid molecular diagnostic systems like GenMark’s ePlex Blood Culture Identification panels could prove to be a game changer in these circumstances, as they can provide comprehensive detection of infectious diseases from patients’ samples, often within a couple of hours - rather than the usual 24 to 36 hours needed for most conventional tests.

“With approximately 20% of UK antibiotic prescriptions currently thought to be unnecessary , improvements in the accuracy and speed of diagnosis when a patient is admitted to hospital can play a huge part in controlling the use of antibiotic medication.”

“These new, high-tech molecular diagnostic systems can also be used to understand specific strains of pathogens—for example by detecting which drug resistance genes they possess—and so which therapies should be avoided,” says Dr Whitfield.

Also valuable for speeding up diagnosis and treatment, GenMark has developed an additional software module for their ePlex system that they call Templated Comments. This capability empowers consultants, microbiologists, pharmacists and other specialists to translate their expertise and treatment suggestions directly onto the ePlex result report and link to specific  test results, which helps the hands-on clinician deliver the right clinical interventions, faster. “Templated Comments doesn’t just speed up time to effective therapy,” says Dr Whitfield. “It also helps ensure antibiotics are more accurately used, if indeed, they are needed at all.”

 

Results can highlight trends for individual hospitals

 

Finally, the information from these rapid diagnostic results can be used to improve  antibiograms for individual hospitals. Antibiograms can be used to track changes in resistance patterns over time, informing the development of therapeutic guidelines, action plans and antibiotic stewardship programmes at the national, regional and local level.

“Although these new tests may appear to be significantly more expensive to run, ultimately, they save hospitals and healthcare authorities money by helping to shorten hospital stays, reducing expensive antibiotic prescriptions, helping to control antibiotic resistance, and, studies2 show, saving more lives,” says Whitfield.

 

1 Davies, SC. (2018) Reducing inappropriate prescribing of antibiotics in English primary care: evidence and outlook. J Antimicrob Chemother. 73(4): 833–834.
2 Timbrook, et al. (2017) The Effect of Molecular Rapid Diagnostic Testing on Clinical Outcomes in Bloodstream Infections: A Systematic Review and Meta-analysis. Clin Infect Dis. 64(1):15-23