By DR. ESTÉE DAVIS AND RAMI PACKARD
The use of antibiotics is the single most important factor leading to antibiotic resistance around the world. Antibiotics are among the most commonly prescribed drug in human medicine. Up to fifty percent of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed.[i]
Nearly everyone in society has heard the name Louis Pasteur. He’s considered one of the most brilliant scientists in history and basically revolutionized the world as we know it. His breakthroughs have saved countless lives and improved the quality of life for people around the world, and his work paved the way for the field of microbiology. In the 1800s, it was Pasteur that first proved that germs make us sick. This led to culture and sensitivity testing that most labs use today to determine what pathogen is causing an illness.
For over 200 years, doctors have been sending samples of wounds, urine, fluids and other bodily parts to labs to be tested and grown. In 3-5 days (sometimes even up to 20 days for fungal infections), doctors would hope to get results so they could then treat accordingly. There are a lot of disadvantages with this test although it’s been the only test available to us at this time. For example, samples have strict storage guidelines and less than 1 percent of known microbes will grow in traditional culture methods. In fact, cultures have a high probability of returning with “no growth” results and anaerobes are extremely difficult to grow in culture.
Advancements have now been made that utilize a new way to test and the ability to get results back to a physician in as little as 24 hours. Molecular PCR testing is the 21st century’s answer to what Louis Pasteur created 200 years ago. PCR technology extracts the Microbial DNA from each sample, similar to lifting fingerprints at a crime scene. Pathogens can be identified with 99.8-99.9 percent accuracy in as little as 24 hours. All microbes and fungi can be tested in one test and the test can detect antibiotic resistance genes for 8 antibiotic classes. The most significant factor that this testing allows is accurate data of what is living inside your patient’s infection so you can be confident in your treatment decisions for their recovery and overall health.
A few labs have converted to this much more accurate and timely testing method and can perform testing on pathogens including wounds, nails, GI, GYN, UTI and RESP. In fact, the CDC has released a paper with guidance for influenza outbreak management in healthcare facilities in response to the flu. [ii]
- In order of priority, the following influenza tests are recommended: 1) PCR 2) Immunofluorescence 3) Rapid Influenza diagnostic tests
- Because of the possibility of false negative results, if immunofluorescence or rapid influenza diagnostic test results are negative, perform confirmatory testing using PCR testing.
- Because of the possibility of false positive results with rapid influenza tests, perform testing using PCR.
Doctors rarely receive accurate timely answers with traditional testing. Traditional approaches to identify the pathogens responsible for enteric infections can be time consuming and lack sensitivity, which can lead to misdiagnosis. They face a large burden from a variety of respiratory tract infections which can be very expensive and difficult to diagnose. Urinary Tract Infections are one of the most commonly diagnosed illnesses in older adults and one of the leading reasons antibiotics are prescribed in long term care facilities. All of these statements are reasons to find a lab that can give your office results in 24 hours.
If your lab is not currently offering you the following services, I encourage you to find one that does.
Key benefits to Molecular PCR testing:
- 24-hour results
- Identifies difficult to culture pathogens
- Reduces antibiotic utilization
- Identifies bacteria regardless of recent antibiotic use
- Improves patient outcomes
- Cost reduction and avoidance
- Increased patient satisfaction
- Yields greater than 95 percent analytical sensitivity and specificity
Molecular PCR testing is covered by traditional and Medicare Advantage plans.
Dr. Estée Davis, PharmD, owns an RX2Live franchise in Melbourne, FL. RX2Live is the only Medical Services Franchise to offer over 18 services for all physician types including specialists and nurse practitioners. She specializes in improving care scores while increasing revenue with NO out of pocket costs to the practice. To learn more about how your practice can benefit from implementing medically necessary procedures into your daily routine, contact or visit edavis.rx2live.com
Rami Packard is a Regional Developer for RX2Live and assists the growth of medical practices and helps keep their patients well. She also assists with senior and corporate wellness programs. Visit https://livewell.rx2live.com/ or contact her at rpackard@rx2live.com
[i] www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf
[ii] CDC. Outbreaks of 2009 Pandemic Influenza A (H1N1) Among Long-Term Care Facility Residents ---Three States, 2009. MMWR 2010:59(03): 74-77 (http://www.cdc.gov/mmwr/previewmmwrhtml/mm5903a3.htm)
