Challenges in identifying antibiotic resistance targets for point-of-care diagnostics in general practice

Mitsakakis, Konstantinos; Kaman, Wendy E; Elshout, Gijs; Specht, Mara; Hays, John P

in part be calculated via POC-assisted measurement of nonspecific biomarkers of infection, for example, C-reactive protein (CRP) and procalcitonin (PCT), though nonspecific biomarkers do not indicate if a bacterial pathogen is resistant to a particular antibiotic or not [8, 9] . Further, if a bacterial infection is indicated or detected, there is still a chance that GPs may prescribe an antibiotic that is not suitable for that infection due to a lack of information on the possible expression of antibiotic resistance by the causative bacterial pathogen. Therefore, in cases where a bacterial infection is established, it could be potentially useful if GPs were also able to determine not only the presence of bacterial or viral pathogens, but also the presence of antibiotic resistances. In practice, however, the actual choice and feasibility of developing antibiotic resistance detection panels for use in POC diagnostics in primary care may be more difficult than is generally appreciated by POC innovators, microbiologists and GPs. In this article, the authors highlight some of the major challenges and barriers that currently exist in choosing antibiotic resistance targets for use in POC diagnostics by GPs ( Table 1 ). The material presented is based on discussions that took place as part of the EU-funded H2020 Diagoras project (www.diagoras.eu), which intends to develop a POC diagnostic device for use by GPs and dentists.