Tuesday , 16 January 2018

The breath test that proves which patients really DO need antibiotics – and could help slow the drug resistance crisis

A simple breath test could soon help doctors in the war against superbugs.

Scientists have worked out how to instantly tell whether someone needs antibiotics for a chest complaint.

The research, which experts hope will eventually be used to build a licensed breath test, could slash the rate of antibiotics prescribed for coughs and colds.

Experts fear that the overuse of antibiotics is driving a superbug epidemic that will kill more people than cancer by 2050.

GPs doling out too many drugs, particularly for complaints where they are not needed, means that bacteria are evolving to become resistant to the treatments.

A simple breath test which identifies if patients really need antibiotics could prevent a health crisis caused by over-prescription of the drugs

Superbugs are already breeding at a rapid rate, with increasing numbers of germs evolving to become untreatable with what were previously effective drugs.

The Government’s superbugs tsar, Lord Jim O’Neill, last month called for GPs to be banned from prescribing any antibiotics at all by 2020 without a test proving they are needed.

His report, personally commissioned by David Cameron, warned that too often doctors prescribe antibiotics based on a ‘guess’ as to whether an infection is present ‘just in case’.

‘This process has remained basically unchanged in decades,’ it said.

Few instant tests for infections exist – with current procedures meaning a delay of a week or more before a laboratory can confirm that a patient has a bacterial infection which requires antibiotics.

But Lord O’Neill insisted that if Governments impose strict rules requiring an instant test result, scientists and companies would provide the technology.

The new research, published by a team in China, suggests his confidence was warranted.

If their findings can be converted into a simple breath test, it will be especially helpful for ruling out antibiotics for the millions of people who report to GPs each year with colds and flu.

While many patients complain that they have a chest infection, most of the cases in reality are caused by a virus, against which antibiotics are useless.

The research, published in the Journal of Breath Research, has identified airborne compounds that are exhaled by patients who have severe respiratory infections.

The team at Zhejiang University in China claim their test could also give doctors an early warning that someone is suffering from life threatening problems such as pneumonia, which is often dismissed as a milder infection.

Researcher Kejing Ying said: ‘To confirm whether patients have a bacterial infection of the respiratory tract, doctors currently have to take a number of different samples – blood and sputum – and even chest x-rays in the case of pneumonia.’

The team analysed samples from 60 patients, and found that patients who exhaled certain compounds also had a certain bug called acinetobacter baumannii in their lungs. These patients were later diagnosed with bacterial pneumonia.

Dr Ying said that the team is yet to overcome a crucial challenge – that many compounds are not unique to one type of bacteria.

Experts fear overuse of antibiotics is driving an epidemic that will kill more people than cancer by 2050

But they are conducting further tests to make it more accurate, and hope to eventually build a breath machine which can provide early warning of bacterial infection.

Dame Sally Davies, the Government’s chief medical officer, has repeatedly warned that medicine will be taken back to the ‘middle ages’ if we do not deal with the superbugs problem, comparing the scale of the issue to that of terrorism.

Dr David Brown, chair of the science committee of Antibiotic Research UK, said: ‘It is truly shocking that in the 21st century we cannot quickly tell if a chest infection is caused by a bacterium or virus.

‘There is a really urgent need for a rapid, cheap and accurate point-of-care test that doctors can use to assess whether an antibiotic should be given because the chest problem is caused by a bacterium.

‘The urgent need is well-recognised and many groups around the world are trying to come up with a solution.’

Dr Maureen Baker, chair of the Royal College of GPs, said: ‘Growing resistance to antibiotics is a global concern, so a test that definitively tells us whether an infection is bacterial, and therefore treatable with antibiotics, would be incredibly useful for prescribing healthcare professionals, GPs included.

‘This study is small, and it’s clear that development of this test is in its early stages, but it is promising and has the potential to be a powerful tool in reducing antibiotics prescribing, and ultimately curbing resistance to antibiotics, which are excellent drugs when used appropriately.

‘Healthcare professionals across the UK are already taking warnings about inappropriate antibiotics prescribing very seriously, and recent figures have shown that prescribing has decreased 7.3 per cent over the last year alone.’

Source: www.dailymail.co.uk

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