By the bioMérieux Connection Editors
Worldwide escalation in antimicrobial resistance has sparked fear of a looming post-antimicrobial era. Antibiotic overuse and inappropriate use—including over-prescribing, inaccurate, and suboptimal prescribing—promotes bacterial evolution and resistance to treatment. Currently, antimicrobial resistance leads to 35,000 deaths annually in the U.S. and 700,000 deaths annually worldwide. By 2050, estimates predict 10 million deaths per year globally, with cumulative economic costs of at least $100 trillion if actions are not taken now to curtail antimicrobial resistance. In addition, we are observing rising resistance in non-bacterial infections, such as the fungus Candida auris, broadening concerns about resistance to encompass all microorganisms.
Antimicrobial resistance is a crisis that we must tackle with technologies built specifically to address its unique challenges. Clinical informatics software can play an important role in providing hospitals and labs with infectious disease data and insights, including visibility to the value and role of diagnostic tools in supporting antimicrobial stewardship.
“When lives are at stake, access to data and speed to insight are critical,” says Dr. John Hurst, Sr. Director of Antimicrobial Stewardship at bioMérieux.
Actionable data is key, because it supports decision-making that directly impacts patient outcomes and facilitates collaboration for true “handshake stewardship.” As explained by the authors of an article in The Pediatric Infectious Disease Journal, “Handshake stewardship is distinguished by: (1) lack of restriction and preauthorization, (2) review of all prescribed antimicrobials and (3) a rounding-based, in-person approach to feedback by a pharmacist-physician team.”
To make handshake stewardship both efficient and effective, antimicrobial stewardship teams need access to data from a range of systems, including laboratory, pharmacy, and electronic health records (EHR). Timely data collection from diverse and siloed hospital systems has often been a challenge, requiring an enormous amount of work on the part of antimicrobial stewardship teams. However, recent advances in technology, particularly cloud computing and machine learning, can provide the type of integrated, real-time analysis that clinicians need to track evolving antimicrobial resistance, improve diagnostic utilization, and deliver better patient care.
Real-time analysis is particularly important because antimicrobial resistance is a moving target—microbes are constantly evolving. Antibiograms, which are in-depth, location-specific profiles of microorganisms and their antibiotic susceptibility, are critical tools in clinicians’ fight against antimicrobial resistance. Hospitals typically take months to produce them because of the sheer quantity of data that must be analyzed. By the time the antibiogram is produced, the actual microorganisms and their resistance profiles may have already changed. That’s a problem for clinicians who must make empiric therapy decisions for patients with symptoms of infection. However, integrating disparate data systems and automating the analysis process can help by providing clinicians with up-to-the-moment and even patient-specific antibiograms. Better quality data means clinicians can make better treatment decisions, leading to improved patient outcomes.
Alongside antimicrobial stewardship, diagnostic stewardship has become increasingly important in delivering value-based healthcare. Diagnostics also have a direct impact on antimicrobial stewardship because they provide data that clinicians need to make treatment decisions. Therefore, optimizing the use of diagnostics can contribute to the overall quality of care. With a holistic view of antimicrobial and diagnostic use, stewardship teams can implement new strategies and evaluate their efficacy. Continued technological developments will simultaneously add depth and efficiency to stewardship programs, equipping clinicians to meet the challenges of antimicrobial resistance today and tomorrow.
Opinions expressed in this article are not necessarily those of bioMérieux, Inc.