Saturday, 21 January 2017

Inaccurate diagnosis of fungal infection aggravates antibiotic resistance

Inaccurate diagnosis of fungal infection aggravates antibiotic resistance Indiscriminate use of antibiotics is a major contributory factor in the escalating problem of antibiotic resistance, a fact which we are all well aware of. The first global report on antibiotic resistance “Antimicrobial resistance: global report on surveillance” released by the WHO in 2014 highlighted antibiotic resistance as a significant public health problem, which was prevalent worldwide across all age groups. Now a new study published in the February 2017 issue of CDC’s journal Emerging Infectious Diseases says that lack of routine diagnostic testing for fungal diseases exacerbates the problem of antimicrobial drug empiricism, both antibiotic and antifungal. Aptly titled “Delivering on antimicrobial resistance agenda not possible without improving fungal diagnostic capabilities”, the study concluded that “the lack of availability and underuse of nonculture fungal diagnostics results in overprescribing, prescription of unduly long courses of antibacterial agents, and excess empirical use of antifungal agents and leaves many millions of patients with undiagnosed fungal infections”. Four common clinical situations have been cited as examples, where lack of routine diagnostic testing for fungal diseases often worsens the problem. · Inaccurate diagnosis of fungal sepsis in hospitals and intensive care units, resulting in inappropriate use of broad-spectrum antibacterial drugs in patients with invasive candidiasis. · Failure to diagnose chronic pulmonary aspergillosis in patients with smear-negative pulmonary tuberculosis. · Misdiagnosis of fungal asthma, resulting in unnecessary treatment with antibacterial drugs instead of antifungal drugs and missed diagnoses of life-threatening invasive aspergillosis in patients with chronic obstructive pulmonary disease. · Overtreatment and undertreatment of Pneumocystis pneumonia in HIV-positive patients. Improving and adhering to diagnostic tests for fungal diseases will help curb the inappropriate use of antibiotics, which compromises measures to control antimicrobial resistance. (Source: Emerging Infectious Diseases. 2017;23(2):177-183)

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