Antibiotic resistance is an emerging crisis. As early as 1945, Sir Alexander Fleming raised the alarm regarding antibiotic overuse when he warned that the “public will demand the drug… then will begin an era… of abuses.” The overuse of antibiotics clearly drives the evolution of resistance. At Assurance Scientific Laboratories, we do not believe in faulting patients demanding antibiotics or prescribers writing them incorrectly. The tools to make the correct decision have not been readily available to them.
Interestingly, most if not all antibiotic stewardship programs fail to include the most important weapon to win this war – pathogen identification. Timely, accurate, and precise pathogen identification is the only way this war can be fought and won. Without pathogen identification, we lose. Yet, this obvious piece is consistently omitted from stewardship programs.
Current antibiotic stewardship programs are based on pathogen suspicion and limiting antibiotics, usually after a wait-and-see approach. However, most common syndromic infections present similarly and are caused by more than 200 common pathogens, many are bacterial. Intellectual suspicion for which of these 200+ pathogens is the culprit, is equivalent to guessing.