In vitro diagnostics and antibiotic resistance: The future is now
Barbara is Managing Director of BIVDA and a member of the Longitude Prize Advisory Panel.
The final report of the Review on AMR echoed a message that is becoming more and more prominent in the antimicrobial resistance (AMR) discussion: diagnostics have a vital role to play. Indeed, the findings of Lord O’Neill and his team led them to state that "rapid diagnostics can transform the fight against superbugs by changing the way we use antibiotics." This is extremely encouraging and supports the British In Vitro Diagnostics Association's (BIVDA) work demonstrating the value of diagnostics in a conversation that is often dominated by a focus on the need for new antibiotics.
The ambition of the Longitude Prize to encourage the development of a revolutionary diagnostic test that is able to ‘do it all’ is an exciting challenge for the diagnostics industry. From a personal point of view, it is a privilege to be a judge for the Prize and witness the array of new technologies coming through from a broad range of backgrounds (physics, chemistry, materials manufacturing etc.). I have been involved in the IVD industry for over 20 years, and hope my experience in the development and commercialisation of in vitro diagnostics can provide some perspective on practical issues of the Prize such as regulatory requirements and studies.
The Prize is driving innovation and we are starting to see some really interesting, novel approaches to tackling the issue of AMR. There are already many tests that can identify specific infections or specific resistance traits, but combining all of these features into one product that can be used in any setting, anywhere in the world, has yet to be achieved.
Currently available tests have generally been designed to address particular needs in a certain setting, so the idea of a universal solution requires the industry to look at things a little differently. Not only is this technically difficult, but other hurdles also have to be cleared, such as regulatory requirements, in order for countries to adopt such a test with confidence. Industry is looking forward to tackling this head on!
While we wait for a prize winner, however, it is important people don’t mistakenly believe that there is nothing that can be used to guide antimicrobial prescription today, when in fact there is a wide range of tests that can help us right now.
The successes seen in the Netherlands and Scandinavia, for example, show that the use of diagnostic tests, both in hospitals and the community, can greatly improve antibiotic stewardship and, in so doing, limit AMR. They are important tools to be used while we work towards the Holy Grail of AMR diagnostics!
In vitro diagnostics are a crucial tool that can help guide treatment immediately by identifying an infection and/or resistance traits. Whether they are used in the lab or at the point of care, IVDs enable informed decision making that will benefit both the specific patient and the wider community: right patient, right drug, right time.
The Review on AMR quotes a US study of respiratory problems that amazingly showed that "more than two-thirds of courses of antibiotics were likely to have been inappropriately prescribed for conditions that were not infections at all, or infections caused by viruses." Diagnostics can be used to drastically reduce such inappropriate usage of antibiotics for viral infections, and so much more.
It is fantastic that when voting for the current Longitude Prize, the public recognised that AMR is a serious issue, and how diagnostics are key in addressing this. There are already tests waiting to be used, but we look forward to discovering a real game-changer. In doing so, we can prevent what some are calling a "post-antibiotic era" – something we would all like to avoid!