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Why clinical laboratory testing is key to fighting antibiotic resistance

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Carmen L. Wiley, PhD

President, American Association of Clinical Chemistry (AACC)

Clinical laboratory experts are using innovative new tests to provide doctors with the insights they need to curb unnecessary antibiotic use.

If I asked you what the solution is to the antibiotic resistance crisis, the first thing you might think of is creating new drugs that kill resistant microbes. What you might not realise, though, is that new clinical laboratory tests for infectious diseases are equally important. These tests – and the scientists who develop and perform them – are crucial to preventing antibiotic misuse, which is one of the major drivers of this global health threat.

Overuse of antibiotics – often with patient wellbeing at heart

Antibiotics are indispensable for treating bacterial infections like strep throat or pneumonia, but they don’t work – and shouldn’t be used – for viral illnesses such as the common cold or flu. In the past, however, traditional culture-based tests could take several days to determine whether a patient had a bacterial infection and which antibiotic would treat it effectively. Doctors couldn’t postpone treatment for this long, especially in cases where a delay was potentially life threatening. So instead, they would often prescribe antibiotics automatically while waiting for test results to come in. This practice had patients’ best interests at heart, but unfortunately contributed to rampant antibiotic overuse, which, in turn, has fueled the spread of resistance to these drugs.

Improved testing to reduce default prescribing

To help solve this problem, the scientists who work in clinical laboratories have developed new tests that greatly reduce the time it takes to diagnose infectious diseases. For simpler cases, such as when a patient has a respiratory infection, clinical laboratory experts have created tests that identify bacteria and viruses through their genetic material, and that return results in hours or even in minutes.

For more complex cases, such as surgical infections, clinical laboratory experts have also modified mass spectrometry (a powerful molecular analysis technique originally designed for research) to create tests that rapidly identify up to nearly 200 different microorganisms at a time.

Most of these new tests are less than a decade old, but thanks to their accuracy and speedy turnaround times, they are already essential tools in the battle against antibiotic resistance. Using these tests, clinical laboratory experts can now promptly provide the information that healthcare teams need in order to decide whether antibiotics are the right treatment for a patient. This will help limit unnecessary antibiotic use, while ensuring that antibiotics continue to work for the patients whose lives depend on them.

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