Antibiotic overuse, Superbugs, and a point-of-care test to help tell the difference

It’s an ongoing difficulty: determining whether a sickness is the result of a virus, bacterial infection or an allergy. The symptoms don’t provide many clues.

Australia has one of the highest rates of antibiotic use in the world. Part of the problem, it seems, is that many people expect a prescription for antibiotics if they go to the doctor with a cold or flu.

A Safety and Quality in HealthCare study recently showed that in 2014, 46% of the population was prescribed an antimicrobial, which includes antibiotics.

The overuse of antibiotics can cause bacteria to change and mutate creating drug resistance.  

“Antibiotic resistance has developed because of the overuse and misuse of antibiotics,” said Professor John Turnidge on the release of Australia’s first report on antibiotic resistance in 2016.

“And now, bacterial infections that were once easily cured with antibiotics are becoming harder to treat.”

Drug-resistant antimicrobials are commonly known as superbugs.

Among the bacteria becoming increasingly drug-resistant are: Tuberculosis, Gonorrhoea, Salmonella, Golden Staph (Staphylococcus aureus), Pneumonia (Streptococcus pneumoniae).

Associate Professor Peter Collignon, Director of Infectious Diseases and Microbiology at Canberra Hospital, is quoted on an ABC Science website that: “Overall, there are almost no bacteria where there is not resistance to more antibiotics then there were 10 or 15 years ago.”

The World Health Organisation (WHO) describes antimicrobial drug-resistance as a major public health issue.

In order to help constrain the rise of superbugs, replacing antibiotics with treatments that specifically target the illness-causing bug is critical.

One way to ensure that doctors and clinicians are able to recommend the right treatments is with better diagnostic tests at the point of care.

Point-of-care CRP Test

One such rapid test is the Afinion™ CRP, which uses a small droplet of blood from a finger-prick to measure the level of C-reactive protein in the sample.

CRP test cartridgeIn effect, the CRP test reduces diagnostic uncertainty and will help guide the practitioner in determining whether the cause is viral or bacterial.

The test cartridge is placed inside a touch-screen analyser and can deliver a lab-quality result in 4 minutes.

The test result can determine whether the amount of C-reactive protein in the blood is normal, moderately high, or significantly increased.

If the test returns a result of increased CRP, this may suggest that antibiotics are immediately necessary.

If the result returns a reading of normal, this would suggest that the cause of the illness is likely to be viral and would have no benefit from antibiotics.

Similarly, a moderately high CRP may suggest to the clinician that the infection is self-limiting and could be effectively fought by the patient without antibiotic intervention.

Measures to Protect from Infection

There’s no question that antibiotics have been a revolution since their discovery in the 1940s and have saved many lives. Yet with our over-reliance making them increasingly less effective, how can we reduce our need for antibiotics? An obvious solution is to try to prevent becoming sick in the first place.

Hand washing

Hand washing is possibly the simplest and easiest way to prevent the spread of germs and infection. Hospitals, many general practices, as well as preschools, child-care centres, and some recreational places for children, also have air-drying hand sanitising dispensers.

2018 Flu Vaccines

The annual flu vaccine is also available this April in Australia. There are enhanced flu vaccines available this year after 1,000 people in Australia died of flu-related illnesses in 2017.

The 2018 flu vaccines are Fluad and Fluzone High Dose. They are free of charge for those over 65 years.


While handwashing and the flu vaccines cannot offer complete protection from colds and flu, they may be the closest thing we have to a magic bullet at the moment.


References

WHO ‘Antimicrobial Resistance’

updated January 2018

http://www.who.int/mediacentre/factsheets/fs194/en/

‘Australia’s most comprehensive report on antibiotic resistance released’

Australian Commission on Safety and Quality in Health Care

https://www.safetyandquality.gov.au/media_releases/australias-most-comprehensive-report-on-antibiotic-resistance-released/

Accessed 3 April 2018

“Superbugs” ABC Science Website

http://www.abc.net.au/science/slab/antibiotics/superbugs.htmAccessed 4 April 2018