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Waging the war on
antimicrobial resistance

anti-microbial resistance anti-microbial resistance anti-microbial resistance
Dr Susanne Emmerich
Published November 01, 2022

The impact of antimicrobial resistance can be slowed

Antimicrobial resistance (AMR) is one of the greatest threats to global health, yet it is accelerated mainly by the misuse and unnecessary prescription of antibiotics.1,2  Most antibiotics are prescribed for respiratory tract infections (RTIs) in the primary care setting.3 Implementing C-reactive protein (CRP) point-of-care testing (POCT) has been shown to safely reduce antibiotic prescribing in RTIs4-8 without impacting clinical measures such as rate of recovery or mortality.5-7

Adopting diagnostic systems that markedly reduce antibiotic consumption has been described as a “no-brainer” for governments that are struggling to address the rise in AMR.8

Dr. Margaret Chan, Director General of the World Health Organization (WHO) further emphasizes the importance of incorporating diagnostics into strategies for slowing the spread of AMR. 

“Today, antibiotics are rarely prescribed based on a definitive diagnosis. Having rapid, low-cost, and readily available diagnostics is an essential part of the solution to this urgent problem.”  

Dr. Margaret Chan, Director General of the World Health Organization9

How CRP POCT can help combat AMR

CRP testing has been shown to achieve a reduction in antibiotic prescribing, especially in subgroups with acutely exacerbated COPD10-12 and in the elderly, with lower RTIs in nursing homes.7  Dr. Carl Llor, PhD, MD (Via Roma Health Centre, Barcelona, and the University of Odense, Denmark) highlights that CRP POCT could also have slowed the spread of AMR during the COVID-19 pandemic.13

References

  1. Prestinaci, et al. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health 2015;109(7):309-18.
  2. Llor, et al. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf 2014;5(6):229-41. 
  3. Aabenhus, et al. Biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care (Review). Cochrane Database of Systematic Reviews 2014;11:1-70.
  4. Martínez-González, et al. Point-of-care C-reactive protein testing to reduce antibiotic prescribing for respiratory tract infections in primary care: systematic review and meta-analysis of randomised controlled trials. Antibiotics (Basel) 2020;9(9):610.
  5. Verbakel, et al. Impact of point-of-care C reactive protein in ambulatory care: a systematic review and meta-analysis. BMJ Open 2019;9(1):e025036.
  6. Andreeva, et al. Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group. BMC Fam Pract 2014;15:80.
  7. Boere, et al. Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial. BMJ 2021;374:n2198.
  8. Cooke, et al. Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI. BMJ Open Respir Res 2020;7(1):e000624.
  9. O´Neill. The review on antimicrobial resistance. Tackling drug-resistant infections globally: final report and recommendations. 2016. Available at: https://amr-review.org/sites/default/files/160518_Final%20paper_ with%20cover.pdf 
  10. Butler, et al. C-reactive protein testing to guide antibiotic prescribing for COPD exacerbations. NEJM 2019;381(2):111-20.
  11. Llor, et al. Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice. Ther Adv Respir Dis 2013; (3):131-137.
  12. Strykowski, et al. An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD. Family Practice 2015;32(4);395-400.
  13. Llor. CRP rapid testing for suspected COVID-19 could slow the spread of antimicrobial resistance. Health Europa 2021;19:20-21. 

© 2022 Abbott. All rights reserved. All trademarks referenced are trademarks of either the Abbott group of companies or their respective owners. Any photos displayed are for illustrative purposes only. 

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