Faster ID of dangerous bugs in the offing. But will it make a difference?

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Yesterday we wrote about a program designed to provide guidance about when antibiotics should be used and which kind (broad or narrow spectrum) of drug should be used.

The essence of the problem is that doctors are overprescribing antibiotics, and overusing broad spectrum drugs, which are more likely to kill good bacteria and thus enable resistant strains to take over. And, of course, knowing the specifics about an infecting organism will avoid treating with the wrong antibiotic and losing precious time.

Part of the issue is patient demand, and it is difficult for a physician to tell a sick patient that they should not be taking antibiotics, especially since it has been so commonplace.

A large part of this issue is technical. It takes 48 hours for a bacterial culture to grow, which often forces doctors to make educated guesses, and also raises the discomfort level of both doctors and patients, since a 2-3 delay for someone who really does need antibacterial treatment can be frightening.

But only a day after our report, we find that this may all change due to some groundbreaking and elegant science. A device called VITEK MS, invented by the French company bioMérieux was just approved by the FDA. What this instrument can do is nothing short of amazing.

VITEK, which is based on a long-used chemistry technique called mass spectrometry (MS), has taken the science many steps further. instead of identifying simple molecules, it can detect 193 different pathogens, both yeasts and bacteria.

ACSH s Dr Josh Bloom is impressed. He says, Instead of two (often more) days to determine the identity of a pathogen, this instrument can do so in less than a day. This could potentially provide doctors with very fast and accurate information, which would then impact the way antibiotics are prescribed.

He is not alone. According to an article in The Wall Street Journal, The Cleveland Clinic recently named the technique as one of the Top Ten Breakthrough Medical Technologies of 2013.

But impressive technology does not necessarily yield impressive results.

ACSH advisor Dr. David Shlaes gives us a reality check. As a former practicing infectious disease physician, he knows the realities of hospital life.

He notes, Rapid diagnostics are slowed by hospital logistics and work rules. For example, CLIA (Clinical Laboratory Improvement Amendments) established in the late 1980s by the FDA requires that only certified laboratories are allowed to process patient specimens for diagnosis.

He continues, This is the slow step. A sample is taken from a patient on a hospital ward or in the ICU. The specimen must then be transported to the laboratory for intake and processing.

Is it open 24/7? Is it even located within the hospital?

I am guessing that this whole procedure saves 8 hours in a 36-48 hour process.