From urgent care for smarter care: use quick tests to fight against antibiotic resistance

Antibiotics have revolutionized medicine, saving countless lives by easily treating deadly bacterial infections. However, today, their power is serious. In the United States, each year, nearly 3 million people develop infections that no longer respond to current antibiotics, and more than 35,000 die accordingly. If serious infectious complications such as Difficult clostridioides (“C. Diff”) Infections – often caused by the use of antibiotics – are taken into account, the toll increases to almost 48,000 per year. A large part of this crisis comes from a simple fact: antibiotics are excessively prescribed, especially in urgent care clinics and emergency rooms. The polymerase chain reaction) helps doctors to make better treatment choices – and to fight against antibiotic resistance along the way.

Why surprise to you

Some antibiotics are only effective against specific bacteria – and rarely, if not, against viruses. However, with colds, flu, sinus infections and throat pains, all mixed in an occupied clinic, distinguish their source on the basis of symptoms alone can be difficult. To play safely – or sometimes to satisfy the patient’s expectations towards a prescription – clinicians often give antibiotics “in case”. Over time, conditions such as Staphylococcus Aureus (STM) Resistant to Methicillin and Enterococci Resistant Vancomycin (VRE) are emerged from this practice. These “superbacing” are much more difficult – and sometimes almost impossible – to be treated. Each unnecessary prescription puts not only the individual patient at risk of side effects of the drug, but it also swallows the capacity of the system to fight against bacterial diseases in the future.

What is the frequency of the problem?

This level of overcrowding increases health care costs, fills hospitals with more difficult to treat and exercise an unfair burden for patients and clinicians who take care of them.

Enter multiplex PCR: a faster, precise and complete diagnostic strategy

Initially developed in the 1980s, the PCR (chain reaction by polymerase) amplifies tiny fragments of the genetic material of an organism, which allows them to be detected in a patient sample. RT-PCR (reverse transcriptase PCR) adds a step that converts RNA (genetic material in many viruses) to DNA, which makes it possible to detect a wide range of microbes, including bacterial and viral species. Multiplex PCR is a process by which a sample, from a given bodily site, is tested for a predefined list of viruses and bacteria, based on the most common disease organisms.

Speed ​​is the most significant advantage. Traditional blood crops or expectations can take days to give results, but RT-PCR can provide results in a few hours, or even a few minutes, thanks to more recent technology. This quick turnaround helps doctors, namely precisely what they treat before issuing a potentially inappropriate prescription.

There are several other advantages of RT-PCR tests for infectious diseases

1. Targeted therapy: instead of broad spectrum antibiotics that try to kill “everything”, doctors can choose a precise antibiotic adapted to the body in question (or decide that no antibiotic is necessary).
2. Less unnecessary prescriptions: studies show that when RT -PCR is available, the use of antibiotics decreases – sometimes by almost half – because clinicians feel more confident not to prescribe an antibiotic.
3. Lower health costs: Although the test itself has a cost, hospitals and clinics save money by avoiding costly complications, repeated visits, readmissions and the societal cost of resistant infections.
4. Better results: patients obtain the appropriate treatment faster, recover earlier and avoid the many side effects associated with inappropriate antibiotic treatment. A recent Healthtrackrx survey of more than 700 suppliers revealed that 98% thought that RT-PCR had improved patient results, and almost half of the patients said that patients expressed their appreciation for rapid and precise diagnosis.

When RT-PCR makes sense

All throat or sniffs do not need RT-PCR tests before a treatment decision is taken. Clinicians can often use a step approach to decide on tests:

1. Initial assessment: a doctor or nurse assesses symptoms, such as fever, cough and sore throat, and risk factors such as age or chronic diseases.
2. Quick service point test: simple and profitable tests (for stroke angina or flu, for example) are carried out in the examination room to govern or get out of common infections.
3. RT -PCR test: If the diagnosis remains uncertain – especially in very sick patients, has recently taken antibiotics or who have other health problems – RT -PCR identifies the microbial culprit in hours.

This sequence maintains reasonable costs and waiting times while giving access to advanced tests and appropriate treatment when it is the most important.

Carefully read the results

Our bodies naturally house many harmless bacteria and mushrooms. RT-PCR is so sensitive that it can collect tiny quantities of these microbes which do not cause disease. For example, someone can wear a normal bacteria in their nose without it causes a sinus infection. To avoid treating these harmless “colonizers”, laboratories often report the amount of a microbe they find in a sample. Higher levels can suggest real infection, while very low levels generally suggest a different etiology. Doctors use these clues, alongside a patient’s symptoms, to decide whether the treatment is really justified.

Overcome practical obstacles

The COVVI-19 pandemic has shown that RT-PCR can be deployed quickly if necessary, but it has also highlighted certain challenges that remain for the use of routine of this test modality:

• Training suppliers: Clinicians need advice on the interpretation of daily disease results.
• Integration of the workflow: clinics must adapt the gentle test stages in the scheduled schedules to avoid long waiting times and processing delays when indicated.
• Insurance coverage: reimbursement policies are sometimes late on innovative technologies, which makes clinicians more difficult to invest in useful diagnoses.

Patient education is just as important. When doctors explain that waiting for a specific test protects patients – and the community – against resistant infections, most people are understanding and supporting.

Work together for a healthier future

Resistance to antibiotics is not a problem only one doctor, clinical or hospital system can solve alone. It requires collaboration between:

• Health care organizations, to adopt and finance new test strategies.
• Diagnostic companies, to continue to improve speed and ease of use.
• The decision -makers and insurers, to update the reimbursement policy, the advanced tests are therefore accessible.
• Patients must understand why an antibiotic is not always the best first step for their disease.

By making RT -PCR tests an option of routine in ambulatory and urgent care environments – and by educating all stakeholders along the clinical continuum – we can considerably reduce the use of unnecessary antibiotics, protect the effective drugs that we still have and ensure that bacterial infections remain treatable for future generations. Antibiotics remain one of the largest weapons of medicine in the fight against disease. With more innovative diagnoses and a shared commitment to use antibiotics judiciously, we can extend their lifespan and protect public health for the future.

Photo: cavan images, getty images

This message appears through the Medcity influencers program. Anyone can publish their point of view on business and innovation in health care on Medcity News through Medcity influencers. Click here to find out how.