Adrian Wilkinson, Business Development Manager, Randox HealthFollowing the review on antimicrobial resistance, “Tackling drug-resistant infections globally,” that was published last week, antibiotic resistance has been making headlines every day.
Antibiotic resistance is growing at a rapid rate, with many ‘superbugs’ becoming completely unresponsive to antibiotics. This is in part due to the way in which antibiotics are prescribed in the primary and secondary care settings.
Every year there are 6.1 million consultations1 with GPs for respiratory tract infections – costing the NHS £501 million2.
The colossal costs are not surprising, given that 70% of GPs have admitted that they prescribe antibiotics in spite of being unsure whether they are treating a viral or bacterial infection3. Only bacterial infections can be treated with antibiotics.
It is clear that rapid diagnostic tests are urgently needed to identify bacterial and viral infections. With these made available to GPs and to hospitals, patients would be provided with test results that show the cause of their infection, whether or not they need an antibiotic, and if required, the appropriate antibiotic which would successfully treat the infection.
Dr. Margaret Chan, Director General of the World Health Organization has commented;
"Today, antibiotics are rarely prescribed based on a definitive diagnosis. Diagnostic tests can show whether or not an antibiotic is actually needed, and which one. Having rapid, low-cost, and readily available diagnostics is an essential part of the solution to this urgent problem."
However, current NICE guidelines advise that diagnosis of respiratory infections in primary care should not make use of laboratory tests, because they are considered to be costly and time consuming. When a test is conducted, it often takes at least 36 hours to confirm the nature of an infection, and the tests available cannot name and categorise infections as bacterial or viral. C-reactive protein tests, for example, that are currently in use, can only indicate whether a bacterial infection is likely.
By following NICE guidelines, doctors are handing out antibiotics unnecessarily – not only costing the healthcare system millions of pounds, but also allowing strains of bacteria to develop resistance to antibiotics.
Given that 90% of GPs have felt under pressure from a patient to prescribe antibiotics4, more often than not, even with no definitive diagnosis, an antibiotic is prescribed. Annually in the US, out of 40m people who are given antibiotics for respiratory issues, a staggering 27m get antibiotics unnecessarily, and only 13m who need antibiotics get them5. Antibiotic prescription amounts to little more than guess work.
The advice from our scientists at Randox Health is simple. No diagnostic test? Then no antibiotic. For the estimated one million hospital admissions for respiratory conditions in England alone6, earlier diagnosis could identify patients suffering with a viral infection, and those suffering with a bacterial infection, and allow medical staff to treat accordingly.
The length of hospital stays would be reduced, and likewise the current cost from respiratory disease to the NHS and to society – over £6 billion7.
At Randox we have developed a test that within hours, can rapidly detect and identify up to 22 different pathogens (viruses and bacteria) that cause respiratory tract infections, for both the lower and upper respiratory tract, and can also identify co-infections. With fast and accurate diagnosis that can inform appropriate treatment, patient outcomes will improve, and private health providers will benefit from fewer health complications, fewer deaths and less time in hospital.
The reality is that with all healthcare management, precise, rapid, and informative diagnosis allows for early treatment intervention and potentially avoids exacerbations or the need for hospitalisation. It allows for more effective use of medicine resources – whether this is antibiotics, other medication, or simply manpower.
Reliable diagnostics are key to effective treatment, and the antibiotic resistance crisis is just one very real example of how they can drastically improve health outcomes and reduce healthcare costs.
Adrian Wilkinson is Business Development Manager at Randox Health, who were the headline partner at the ABI's Future of Health Screening event last month.
References
1NICE costing report 2008
2BTS 2006
3Nesta Longitude Prize 2014
4Nesta Longitude Prize 2014
5Review on Antimicrobial Resistance. Tackling drug-resistant infections globally
6https://www.brit-thoracic.org.uk/delivery-of-respiratory-care/burden-of-lung-disease/ 26th May 2016
7https://www.brit-thoracic.org.uk/delivery-of-respiratory-care/burden-of-lung-disease/ 26th May 2016