Part 3: What role does innovation such as rapid diagnostics have in preventing AMR?
Just as new technology has helped us in the fight against global warming (fuel efficiency, clean energy etc.), technology can also help us in the fight against antimicrobial resistance (AMR). One such area is rapid diagnostics – identified as a key intervention for reducing AMR in the government’s 2016 Review of Antimicrobial Resistance.
For some infections, antimicrobials are prescribed based on a patient’s symptoms rather than a diagnostic test result because there is no test available locally or there is a time delay in receiving test results. Presumptive treatment can lead to unnecessary or incorrect use of antimicrobials.
One example is in the treatment of symptomatic people attending sexual health clinics. The standard laboratory diagnostic test for chlamydia (a common sexually transmitted infection) takes up to a week to process. As the prevalence of chlamydia is relatively high within this group, to avoid treatment delay or the need for a return appointment, people with symptoms indicative of chlamydia are often prescribed the antibiotics appropriate for treating chlamydia. However, chlamydia symptoms can be similar to the symptoms of other infections. Presumptive treatment means that people with a different infection are given the incorrect treatment, which can increase the risk of AMR developing. The use of a rapid diagnostic test for chlamydia means that clinicians can prescribe the most appropriate treatment. Patients with a negative result would have additional diagnostic tests to correctly diagnose the cause of their symptoms.
Rapid tests can assess if an infection is present, and whether the infection is resistant to specific drugs. This means that at the same time as diagnosing an infection, the most appropriate drug can be chosen for treating it. Typically, a resistance test would test for resistance to a first-line drug so that, if there is resistance, a second-line drug can be used. This type of testing is already being used to tackle the growing problem of multidrug resistant TB. In other circumstances, where older drugs have been abandoned due to high levels of resistance, a rapid test could identify which infections could be treated with these drugs, preserving the use of the newer drugs for where there is already resistance.
At Aquarius Population Health, we have worked on many AMR projects with a range of organisations, to assess the burden of disease, and show the economic impact and benefit of rapid diagnostic tests and new drugs on AMR. Learn more about our work in rapid diagnostics. If you are interested in learning more about AMR and the economic benefits that technology can play, then please get in touch.
Dr. Susie Huntington