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Antibiotic wisdom

A new infection diagnostic could smarten antibiotic use

While one of the biggest problems in infectious diseases is the overuse of antibiotics, few point-of-care tools are available to help physicians decide when and what to prescribe. Focusing on host genes rather than microbial ones, a group at Stanford University has developed an assay based on an 18-gene signature that distinguishes viral from bacterial infections and doesn't depend on the species present.

"We are not trying to identify what bugs you have or if the bug is even present. We are simply saying from the host's response it looks like you have bacterial infection," said lead investigator Purvesh Khatri, who is an assistant professor of medicine at Stanford's School of Medicine.

The lion's share of attention on antibiotic resistance has gone to new antibiotic discovery, but there is little dispute that better diagnostic agents are needed. In its 2015 National Action Plan for Combating Antibiotic Resistant Bacteria (CARB), the White House called for activities to "ensure that each patient receives the right dose at the right time for the right duration" within its goal to slow the emergence of resistant bacteria and prevent the spread of resistant infections.

Khatri told BioCentury that although some fast PCR-based assays have been developed, they are primarily for viruses and are based on the organisms' antigens,

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