In the latter half of the 20th century, antibiotics revolutionized the world of medicine. Instead of bacterial infections running their course, which often led to death, antibiotics now stop many of them in their tracks, saving millions of lives. But the subsequent emergence of antibiotic resistance and “superbugs” has presented a new challenge for medicine today.
Each year, about 2 million Americans are infected with superbugs, and 23,000 die from these infections. A British review estimated that superbugs could kill around 10 million people worldwide by 2050.
While there are natural causes for bacteria to gain resistance to certain antibiotics, including genetic mutations and the transfer of drug-resistant genes between bacteria, overuse of antibiotics has perhaps had the most significant impact. This has been driven by the all-too-common practice of prescribing an antibiotic when it isn’t likely to help, such as with a simple case of the flu or an upper respiratory infection caused by a virus. Nearly 50 million unnecessary prescriptions for antibiotics are written each year in the US alone.
One reason doctors overprescribe antibiotics — and often the wrong one — is they usually can’t rapidly identify the exact cause of a patient’s infection. In this scenario, it may feel safe to treat an infection with a broad-spectrum antibiotic because it can take up to three days to isolate the infectious organism, culture it, identify it, and determine its drug resistance status — a process which, in many cases, concludes that antibiotic treatment isn’t effective and may even be making the infection worse.
This is where new innovations in engineering and molecular diagnostics can have a significant impact. These techniques can test for infection-causing bacteria and provide accurate identification in under 60 minutes. Lab directors can use them to differentiate between antibiotic-sensitive and antibiotic-resistant bacteria and, if the cause of the infection is viral, antibiotics aren’t needed.
Rapid identification allows a physician to provide the correct treatment in a short time frame, aiding in a better outcome for his or her patient. This is the mission of my company, Great Basin Scientific. By helping reduce the overprescription of antibiotics, we believe that rapid culture diagnostics can help fight antibiotic-resistant bacteria as well as the higher hospital costs and long hospital stays that accompany them.
Of course, overprescribing isn’t the only cause of superbugs. Patients who don’t properly take antibiotics and the largely unnecessary use of antibiotics in the livestock and agricultural industries also add to the problem.
Complicating the treatment of infection further, the pharmaceutical industry, which has long spearheaded development of new antibiotics, has been facing major economic and regulatory obstacles, resulting in 15 of the 18 largest pharmaceutical companies in the world abandoning antibiotic development.
As the Centers for Disease Control and Prevention has outlined in its Get Smart About Antibiotics Week initiative, various partners within the health care delivery ecosystem — clinicians, researchers, administrators, and others — must unite and create awareness about antibiotic resistance. The use of innovative molecular diagnostics and detection systems that offer precise answers should be part of initiatives to ensure the effective, judicious, and correct use of available antibiotics in treating infections.
Robert Jenison is chief technology officer and senior vice president of research and development at Great Basin Scientific, a molecular diagnostics company.