Improved Utilization of Diagnostics will Better Inform Stewardship Practice

A new publication shows that improved diagnostic utilization is required for impactful antibiotic stewardship programs.   

Despite antimicrobial resistance being a topic of global importance and the reported positive impact of diagnostic technologies and antimicrobial stewardship efforts, barriers to appropriate use of diagnostic utilization and effective antimicrobial stewardship practices widely exist. This research aimed to obtain insights from healthcare professionals on current challenges and identify opportunities for optimizing diagnostic and antimicrobial stewardship efforts. 

To learn more about the findings, please read below, and to learn more and read the publication. 

Antimicrobial stewardship (AMS) programs aim to improve appropriate use of antimicrobials. Diagnostic testing plays an important role in these programs by identifying the microbes responsible for infections so patients can be given the right treatment as quickly as possible. 

The new publication, “Opportunities to Enhance Diagnostic Testing and Antimicrobial Stewardship: A Qualitative Multinational Survey of Healthcare Professions”, obtained the perspective of healthcare professionals on the challenges of and ways to improve diagnostic testing and antimicrobial stewardship programs. 

Overall, the study found that healthcare professionals (HCPs) consider diagnostic tests to be an important part of antimicrobial stewardship, but there are several barriers to their success, including patient/hospital costs, turnaround time of test results, resourcing, antimicrobial resistance, and education.  

As stated in paper, “While some barriers differ by country, these survey results highlight areas of opportunities in all countries for improved use of diagnostic technologies”. 

To overcome these barriers, increased funding, education, and resourcing, regular guideline updates, and development of optimized testing algorithms may help to improve antimicrobial stewardship and ultimately decrease antimicrobial resistance. 

The data: 

• Three hundred HCPs from six countries (representing varied gross national incomes per capita, healthcare system structure, and AMR rates) were surveyed.  Three high-income countries, Germany, Italy, and United States, and three middle-income countries, India, Brazil, and China, were included in the study to allow for similarities and differences between countries to be assessed.  All study participants received the same survey, translated if needed. 

• The findings suggest that the greatest challenges to diagnostic test utilisation were economic in nature. The HCPs reported that AMS initiatives were lacking investment (32.3%) and resourcing (40.3%). 

• It was recognized that AMS initiatives are important and diagnostic practices were acknowledged to have a positive impact on decreasing antimicrobial resistance (70.3%) and improving patient outcomes (81.0%).   

• High resistance rates were considered the greatest barriers to appropriate antimicrobial use (52.0%). The concern on antimicrobial use is directly linked to availability of diagnostic tests.   

• 82.0% of survey participants agreed with the statement “The appropriate use of newly released antimicrobials may depend on suitable diagnostics being available”. 

• 61.3% of survey participants agreed with the statement “The lack of diagnostic test availability is a barrier to the appropriate use of new antimicrobials”.  

• These findings indicate that diagnostic tests are a key to unlock access to responsible, appropriate, and timely use of new antimicrobials.  

Optimized diagnostic practices are most effective in tackling antimicrobial resistance when embedded in an AMS program.  While it was noted that most HCPs found local and national guidelines to be very useful (≥ 51.0%), the gap in available diagnostic tests limited the implementation of the programs.  Demonstration of the value of diagnostic tests is needed to encourage wider test utilization and AMS efforts.  The HCPs agreed that improved diagnostic practices help to decrease antibiotic resistance and improve patient outcomes. These improvements to the healthcare system will help reduce overall healthcare associated costs as well as improve quality of care.