There are now several new antibiotics available to treat multidrug-resistant pathogens, and susceptibility testing methods for these drugs are increasingly available at the time of drug approval. However, lack of clarity regarding verification requirements remains a formidable barrier to introducing such testing in clinical laboratories, making these drugs practically unavailable for patient use. We propose a change in the framework for bringing in testing for new antibiotics, focusing on quality control rather than underpowered verification studies.
Publications by Year: 2019
2019
Kirby, James E, Thea Brennan-Krohn, and Kenneth P Smith. (2019) 2019. “Bringing Antimicrobial Susceptibility Testing for New Drugs into the Clinical Laboratory: Removing Obstacles in Our Fight Against Multidrug-Resistant Pathogens.”. Journal of Clinical Microbiology 57 (12). https://doi.org/10.1128/JCM.01270-19.
Smith, Kenneth P, and James E Kirby. (2019) 2019. “Rapid Susceptibility Testing Methods.”. Clinics in Laboratory Medicine 39 (3): 333-44. https://doi.org/10.1016/j.cll.2019.04.001.
With emerging antimicrobial resistance, rapid antimicrobial susceptibility testing (AST) is needed to provide early definitive therapeutic guidance to optimize patient outcome. Genotypic methods are fast, but can identify only a subset of known resistance elements. Phenotypic methods determine clinically predictive minimal inhibitory concentrations and include very sensitive optical and biophysical methods to detect changes in replication or physiology of pathogens in response to antibiotics. For the potential of rapid AST to be fully realized, results must be linked with robust decision support solutions that will implement therapeutic changes in real time.