title: Diagnostics as essential tools for containing antibacterial resistance.
abstract: Antibacterial drugs are overused and often inappropriately selected. This exacerbates drug resistance and exacts a high burden from acute respiratory tract, bloodstream, sexually-transmitted, diarrheal and other infections. Appropriate use of existing diagnostic tests, and developing better ones, could avert these costs and would avoid selective pressure from unnecessary antibacterial use. Product profiles of resistance-averting tests would specify WHO 'ASSURED' (Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free and Deliverable) criteria and request susceptibility as well as etiological information. Advances in genomics, nanoscience, microfluidics and bioengineering, as well as innovative funding paradigms can help to overcome research and development barriers for such diagnostics if they are deliberately and forcefully applied. Rapid uptake of new tests requires timely translation of research on cost-benefit analyses into policy, value-based subsidies and reimbursements, as well as behavioral change of health care providers and users.
authors.affiliation: Department of Biology, Haverford College, 370 Lancaster Avenue, Haverford, PA 19041, USA. iokeke@haverford.edu
authors.forename: Iruka N
authors.initials: IN
authors.lastname: Okeke
authors.forename: Rosanna W
authors.initials: RW
authors.lastname: Peeling
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
authors.forename: Raymond
authors.initials: R
authors.lastname: Auckenthaler
authors.forename: Stuart S
authors.initials: SS
authors.lastname: Olmsted
authors.forename: Jean-François
authors.initials: JF
authors.lastname: de Lavison
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Zimmer
authors.forename: Mark D
authors.initials: MD
authors.lastname: Perkins
authors.forename: Katarina
authors.initials: K
authors.lastname: Nordqvist
mesh_terms: D000900:Anti-Bacterial Agents / Q000138:chemical synthesis / Q000627:therapeutic use*; D001419:Bacteria / Q000472:pathogenicity; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D001681:Biological Assay; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D055808:Drug Discovery; D024881:Drug Resistance, Bacterial; D023281:Genomics / Q000379:methods; D057166:High-Throughput Screening Assays; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D044085:Microfluidics / Q000379:methods; D025202:Molecular Diagnostic Techniques
chemical_list: D000900:Anti-Bacterial Agents