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

ic innovators need to have access to up-to-date epidemiological data on antibiotic resistances for their target healthcare settings; and the existence of novel antimicrobial resistances, or the introduction of antimicrobial resistances from neighboring geographical locations or communities, may be missed. Further, if POC diagnostic innovators include many tens of antibiotic resistances in their detection panels, will GPs be knowledgeable enough about the significance of the different resistances for their patients? Will the relevant POC diagnostic therefore have to provide advice to the GP, dependent on the antibiotic-resistant results? Giving such advice could be seen as advising the GP how to treat the patient, rather than the GP making his own decision. This may have legal and ethical implications. Finally, as the number of POC diagnostic antibiotic resistance targets increases, so does the price of the diagnostic, which may negatively affect the value: cost ratio of the diagnostic. GPs may then perhaps ask themselves why they need to buy a diagnostic that detects many different antibiotic resistances that may not be relevant to their own geographical location or community.