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

Choosing useful antibiotic resistance gene targets for use in POC diagnostics by general practitioners is not an easy task. Currently, the choice is particularly limited by: the diversity of antibiotic resistance mechanisms present in general practice; a lack of epidemiological information on the origin and spread of antibiotic resistance mechanisms within particular geographical locations and within particular communities; and limitations on currently available POC diagnostic technologies to rapidly detect the many different types of antibiotic resistance mechanisms known. Lesser problems include: the inaccuracy of predicting future trends in antibiotic resistance; and a lack of knowledge of the impact of the human microbiota on antibiotic resistance carriage and antibiotic treatment failure. It should future science group www.futuremedicine.com be noted that, even if the above challenges are successfully overcome, the success or failure of the implementation of future POC antibiotic resistance diagnostics into general practice depends on many interacting factors. These factors include the behavioral decision-making process of individual general practitioners, time-to-result and the (perceived) added value of implementing POC antibiotic resistance diagnostics into the GP practice.