Antibiotics and antimicrobial resistance

04/26/2021

Wiesbaden, Germany - April 26, 2021 - Antibiotics and antimicrobial resistance. Another market option according to EDL-3.

Antimicrobial resistance (AMR)

Taking antibiotics for colds and other viral illnesses doesn't work - and it can create bacteria that are harder to kill. Taking antibiotics too often or for the wrong reasons can change bacteria so that antibiotics no longer work against them. This is called bacterial resistance or antibiotic resistance.

Even in Western countries, 30% of antibiotic prescriptions are considered either unnecessary or suboptimal.Overprescribing and uncontrolled use of antibiotics in agriculture lead to antimicrobial resistance (AMR).According to WHO, AMR is the greatest global health threat of the 21st century and requires urgent action. Common infections become untreatable due to the emergence of AMR. More than 700,000 people die each year from drugresistant infections, and this number is expected to reach ten million by 2050.2

Essential Diagnostic List (EDL-3) and antimicrobial resistance (AMR)

During WHO's EDL-3 presentation, Dr. Hanan Balkhy3 (Director, Infection Prevention & Control, Ministry of National Guard Health Affairs, KAMC-Riyadh, Saudi Arabia) emphasized the importance of antimicrobial resistance (AMR). She said AMR is a silent pandemic, made even more important by COVID-19, as funding for general diagnostics has been reduced, yet more antibiotics have been prescribed. She mentioned that C-reactive protein (CRP), procalcitonin (PCT), and other parameters play an important role and it should be the rule in every country: "diagnosis before prescription" of antibiotics. She concluded, that more and more parameters will be mentioned in the EDL that will have this focus. Therefore, we should all make AMR a recurring theme in our sales conversations with customers.

CRP and PCT and its importance for antibiotics prescription

It is critical to distinguish between bacterial and viral infection, as only bacterial infections respond to antibiotics. C-reactive protein (CRP) is widely used as a biomarker for the presence of an inflammatory process and is the most extensively studied marker for distinguishing bacterial from nonbacterial infections in febrile patients. The literature reviewed suggests that CRP testing may be beneficial in resource limited settings to improve the rational use of antibiotics in febrile patients.4 CRP can be determined qualitatively with a simple RDT and quantitatively with a test on a clinical chemistry analyzer. (See HUMAN’s REF 40040/40042 and REF 11141/11241/11241300/1241600, respectively).

Procalcitonin (PCT), another biomarker positive for bacterial infection and sepsis is becoming increasingly popular. PCT is often said to be superior to CRP and more specific for sepsis and bacterial infections. This is because PCT begins to rise earlier and returns to normal concentration more quickly than CRP, allowing earlier diagnosis and better monitoring of disease progression.5 (See HUMAN’s PCT HumaCLIA SR (REF 85820) test kit to be used with the HumaCLIA 150 (REF 15910) system; kit will be available Q2/2021).

Antimicrobial resistance (AMR) – additional background information

Bacteria, not human beings or animals, become antibiotic resistant. Infections with resistant bacteria are more difficult to treat than those caused by non-resistant bacteria. A recent report on antimicrobial resistance calls for testing to identify viral and bacterial infections, because only bacterial infections respond to antibiotics.6 The review team says that these tests could make an end to the so called "just in case" prescriptions, in which a large proportion of antibiotics are used unnecessarily. According to the report, some rapid diagnostic tests already exist that can reduce antibiotic prescription.

For example, blood tests for C-reactive protein (CRP) can give an indication of whether an infection is likely bacterial. Although such tests are not perfect, they have been widely used for years in the Netherlands and Scandinavia, which have some of the lowest antibiotic prescription rates in Europe.

Key facts according to the WHO

  • Antibiotic resistance can affect anyone of any age and in any country.
  • Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals accelerates the process.
  • Antibiotic resistance is now one of the greatest threats to global health, food security and development.
  • A growing number of infections, such as pneumonia, tuberculosis, gonorrhea and salmonellosis, are increasingly difficult to treat because the antibiotics used to treat them are becoming less effective.
  • Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality.

It's not enough to develop new drugs. The discovery of new antimicrobials is too slow to keep up with how quickly microbes evolve to become resistant to old drugs.2 We need to maintain the effectiveness of the antimicrobials we currently have. It is equally important that we move away from broad overprescribing of antibiotics to more targeted therapy.

CONCLUSION

Diagnostics allows for the optimal use of existing medications. A simple diagnostic test that indicates the presence or absence of a bacterial infection can dramatically reduce the overuse of antibiotics. Use the products mentioned above that HUMAN is offering.

Literature

  1. Centers for Disease Control Prevention. Be Antibiotics Aware: Smart Use, Best Care | Features | CDC. Available online (Centers for Disease Control Prevention 2018) at: https://www.cdc.gov/patientsafety/features/be-antibiotics-aware.html (accessed May 28, 2019).
  2. United Nations meeting on antimicrobial resistance. Bull World Health Organ. 2016 Sep 1; 94(9):638-639
  3. dx.doi.org/10.1136/bmjgh-2020-002396 ; 13-04-2021
  4. Meisner M. Procalitonin: Experience with a new diagnostic tool for bacterial infection and systemic inflammation. J Lab Med 1999; 23:263-72
  5. www.bbc.com/news/health-34607822; 13-04-2021