Diagnostic testing helps clinicians target antibiotic therapy
Antibiotics are essential for treating bacterial infections. Prescribing the appropriate medications at the right time and at the right dosage, however, is critical to supporting antibiotic stewardship and preventing antibiotic resistance.
Reviewing the decades-long evolution of antibiotic resistance to Enterobacteriaceae offers insight into the threat.
- Enterobacteriaceae-produced extended-spectrum beta-lactamases (ESBLs) emerged in the 1980s. These ESBLs break down most beta-lactam drugs, leading to antibiotic resistance
- A resulting increase use of carbapenems in the 1990s gave way to a rise in carbapenem-resistant Enterobacteriaceae (CREs)— "broad-spectrum" versions of ESBLs
- A paucity of new medications for treating CRE infections exist
- Increasing numbers of CRE infections and resistance to new medications are likely
- Expanding initial antimicrobial testing system (AST) panels may help avoid subsequent off-line testing that can delay appropriate treatment
Robust diagnostic testing is key not only to addressing CREs, but also to managing the threat of antibiotic resistance overall. Testing helps identify bacterial infections, determine which medications are effective for treating those infections and inform preventions strategies.