Diagnostic tests to mitigate the antimicrobial resistance pandemic—Still the problem child

Novel lateral flow assay for point-of-care detection of Neisseria gonorrhoeae infection in syndromic management settings: a cross-sectional performance evaluation

“…Therefore, implementation of a non-molecular test should be considered to optimise STI diagnosis and treatment with the further benefit of reducing excess antibiotic use, thereby promoting antimicrobial steward ship in syndromic management settings. 28 The NG-LFA meets most of WHO's ASSURED criteria for the ideal rapid point-of-care test in lower income countries. 29 The test sensitivity and specificity were excellent, the test was considered easy to use, 30 and it was implemented at the primary health-care level by the appropriate staff cadres.…”

“…Therefore, implementation of a non-molecular test should be considered to optimise STI diagnosis and treatment with the further benefit of reducing excess antibiotic use, thereby promoting antimicrobial stewardship in syndromic management settings. 28 …”

Cost-effectiveness of point-of-care diagnostics for AMR: a systematic review

“…This is in keeping with existing literature, which has shown CRP POCTs lead to significant reductions in antibiotic prescribing without clear benefits to clinical outcomes. 14 , 16 , 53 …”

“… 1 , 4 In particular, POCTs represent a neglected area within AMR. 53 This systematic review has several recommendations for future research and policy: (i) future studies evaluating interventions that may reduce antimicrobial prescribing should include the cost of AMR in their modelling; (ii) up-to-date estimates for the societal, healthcare and economic cost of AMR are required to inform decisions on the cost efficacy of interventions; (iii) policymakers focused on HICs should consider large-scale evaluation and implementation of CRP POCTs for diagnosis of RTIs in primary care to reduce antibiotic prescribing with concomitant clinical benefits; (iv) funders and researchers should consider further development and evaluation of POCTs that can determine the resistance profile of MDR pathogens such as gonorrhoea, as modelling shows they are likely to be cost-effective; and (v) policymakers focused on LMICs should consider real-world evaluation of POC CRPs for febrile patients given cost efficacy and clinical efficacy in modelling studies.…”

Defining access without excess: expanding appropriate use of antibiotics targeting multidrug-resistant organisms

“…Increased financing of targeted research and development, and making commercially available diagnostics fit for use in resource-limited settings should also be a priority. 36 National authorities could enact policies and interventions to ensure that providers and patients who need these novel antibiotics have access to proper MDR organism identification and antimicrobial susceptibility testing. In cases where local microbiology laboratories have low capacity, efforts could be made to strengthen specimen referral networks using national or subnational reference laboratories and adding to existing successful mechanisms such as those created for tuberculosis and HIV, with timely reporting back to treating clinicians.…”