Home » Antimicrobial Resistance » Biggest AMR dilemma: to give, or not to give antibiotics?

François Ventura, MD, MBA

Intensive Care Physician at Hirslanden Clinique des Grangettes, Anesthesiologist at Geneva University Hospitals and Chief Medical Officer at Abionic

The misdiagnosis of sepsis is leading to an overuse of antibiotics, but early and accurate diagnostics using point-of-care biomarkers can address this problem.

The two main reasons for the use of antibiotics are the treatment and the prevention of bacterial infections.

Overuse of antibiotics

Sepsis (a dysregulated reaction of the body to infection with 50 million cases per year) must be treated with antibiotics as soon as it is suspected — ideally, within the first hour. Antibiotics are thus easily administered at the slightest suspicion of infection, based solely on symptoms and in line with the latest international guidelines, despite bacterial infections being proven in only 30–40% of cases.

Inflammatory conditions with symptoms comparable to sepsis are often mistakenly treated with antibiotics. In addition, antibiotics are frequently given for the prevention of bacterial infections acquired in the hospital. Consequently, it has been estimated that up to 50% of antibiotic prescriptions are inappropriate or unnecessary. A way to reduce the burden of sepsis is to give timely, adequate antibiotics; and a way to reduce the burden of AMR is to withhold unnecessary antibiotics.

It has been estimated that up to 50% of antibiotic prescriptions are inappropriate or unnecessary.

Biomarkers as a solution

The measurement of biomarkers in the blood makes it possible to decide in just a few minutes whether to administer antibiotics or not.

The pancreatic stone protein (PSP) biomarker can be measured in under 10 minutes from a single drop of blood, thanks to an innovative point-of-care technology (abioSCOPE®, Abionic, Switzerland). PSP has shown the capacity to rule out sepsis (90–95% negative predictive value). It could be the biomarker, alongside others, to inform decisions to withhold unnecessary antibiotics.

Daily measurements of PSP in hospitalised patients have shown a unique ability to detect sepsis up to three days before signs and symptoms appear. This early warning provides a life-saving window of opportunity for the administration of antibiotics in patients who truly need them; while a negative result provides physicians with additional support in the decision to withhold antibiotics — making PSP an invaluable tool in the fight against AMR.

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