In an attempt to curb the serious problem of antibiotic overuse, scientists are designing a kit for GPs to quickly diagnose viral versus bacterial infections, writes ISABEL CONWAYin Antwerp
MANY OF US know only too well what it is like to desperately try to fight off an aggressive flu or persistent cough that goes on and on. Armed with an arsenal of prescribed antibiotics we despair, once the medication has run its course because viral-based respiratory infections and common flu were not cured with them. In fact the “cure” has probably done more harm than good, lowering our resistance and even exposing our immune systems to future assault.
It is a frightening statistic: in up to 70 per cent of cases, those of us who are coughing and spluttering, feeling ill, exhibiting the usual flu-like symptoms, desperately in need of a miracle remedy are incorrectly prescribed antibiotics. And that includes infants. Babies are often wrongly diagnosed with bacterial infections – which respond rapidly to antibiotics – whereas they are more likely to suffer viral infections, for which antibiotics are about as useful as sweets, but far more harmful.
In Ireland an older generation of patient presenting with the usual symptoms might have expected nothing less than a course of antibiotics to put them quickly on the road to recovery. Overworked GPs confronted with filled-to-capacity surgeries during peak flu periods would have obliged in good faith, responding sometimes to the powerful pharmaceutical industry, keen to promote every new antibiotic that comes on the market.
Add to that mix bosses who only believed their employees were truly ill and legitimately off work once the magic words “they have me on the antibiotics” were uttered. The delay in identifying the type of infection and whether it is one that needs antibiotics or not further complicates things: laboratory analysis can take from a day to several weeks in the case of viruses.
One of the world’s leading authorities on antibiotic use, Herman Goossens, professor of microbiology at the University of Antwerp, has made the radical reduction of inappropriate use and overuse of antibiotics his mission in life.
Now he and a team of experts – from scientists to high-tech industry and the pharmaceutical sector – are embarking on a unique project, one which he hopes could reduce antibiotics usage by up to 50 per cent. They aim to invent a kit that can quickly tell which infection needs treatment with antibiotics and, importantly, based on a patient’s DNA, which is the most effective way to treat that infection.
The EU-backed multimillion euro project called RAPP-ID (Rapid point of care tests for infectious diseases), launched in April, is spread across some of Europe’s leading research facilities, from Cambridge University, England to Uppsala University in Sweden.
If it is successful, doctors will at last have the tools in their surgeries to tell within half an hour whether their patient has a bacterial infection, which can be treated with antibiotics, or a virus, which cannot.
It may be a far cry from Fleming’s penicillin breakthrough in 1928 but Goossens, who is leading the project, believes that the true value of antibiotics can be far better protected by limiting its usage and safeguarding the public from inappropriate use.
“The days of blockbuster antibiotics are over and the pharmaceutical industry is starting to realise the urgency of protecting those we have as resistant bacteria prove ever harder to kill,” he says.
“Antibiotics save millions of lives and we must be thankful for that. But equally at least 50 per cent of the time they are unnecessarily prescribed. That has serious consequences for patients’ health and the cost of medical care in the western world – and we already know that there is a strong connection between overusage and exposure to hospital superbugs.”
Ireland and the UK, he notes, are not showing anything like the improvements seen elsewhere. In Belgium, for example, antibiotic use has fallen by 36 per cent in the community thanks to campaigns aimed at GPs and at raising public awareness.
Imagine the challenge of shrinking a huge laboratory filled with people and equipment to a single chip the size of a matchbox, muses Prof Goossens as we sit in his office at Antwerp University hospital. He is fingering a plastic card filled with grooves, panels, ports and channels, all of which will deliver comprehensive results, thanks to nano beads, chemical reactions and so on.
“This, if we get it right, will take us to unexplored horizons. We still do not have the technology to quickly diagnose suspected infections and what treatment is necessary,” he says. “It will represent a major breakthrough, as even the best of the currently available diagnostic methods are too slow to help clinicians.”
Once the kit is developed – clinical trials could start within three years – the aim is to make it ultra practical and accessible to the public. Nurses in doctors’ surgeries could do the tests, relieving pressure on practitioners, saving time and medical costs.
“In the future the kit could be like a pregnancy testing kit, a do-it-yourself way of taking a sample of phlegm from your mouth and nose, feeding the kit into a machine in the pharmacy and being able to tell pretty much instantaneously whether you have a bacterial infection or a virus,” says Prof Goossens, eyes glinting with enthusiasm behind Harry Potter-style spectacles.
“There will be fewer doctors and a larger ageing population. People would be able to identify benign infections themselves. They could even feed their test into machines in the local supermarket way into the future.”
For more information on the project, see rapp-id.eu
