You have one hour, but are current diagnostics up to the task?
A new draft quality standard unveiled today by the National Institute for Health and Care Excellence (NICE) highlights the dangers of sepsis and the need for antibiotic treatment within the hour.
High-risk sepsis patients should get antibiotics and IV fluid treatment within the hour. If it will take more than an hour to get someone to hospital, GPs or ambulance staff can also administer antibiotics. - Press Release from NICE
If this isn't a call to action I don't know what is. Today, there has been a lot of national press about sepsis, which was brought about by a new report from NICE. They urge hospital staff to treat sepsis patients with antibiotics within the hour. These important guidelines will undoubtably save lives, but what about antibiotic resistance? There are two problems, the first is that, if we are too quick to treat then we may use antibiotics inappropriately and contribute the the spread of resistance, especially within hospitals. Secondly and far more serious is that, given the current prevalence of antibiotic resistance, what are the chances that the bacteria causing sepsis are resistant to our treatment? As it stands now, there is no alternative. Suspected sepsis patients must be treated immediately with broad spectrum antibiotics to give them a chance of survival.
So, we have work to do. Current diagnostic methods in the clinics don't come close. Any new methods are not being integrated either because they are impractical or too expensive.
Perhaps the winner of the EU Horizon Prize for Better Use of Antibiotics holds the answer. Philips designed a diagnostic device that can tell if a patient has a bacterial or a viral infection in the blood. The analysis can be done in 10 minutes and while it cannot yet determine antimicrobial susceptibility, it can certainly prevent antibiotics being used in the wrong circumstances.
Can we come up with a device that will give us the antibiotic resistance profile within 10 minutes? If something like this could be implemented in hospitals then the global threat of antibiotic resistance would be greatly reduced and we could treat sepsis patients quickly and with the right drugs.