We must be smarter about how we use antibiotics, says Imperial researcher

Not enough focus is being paid to using antibiotics more appropriately to minimise the threat of drug-resistant bugs, said an expert in a recent talk.

Alison Holmes, Professor of Infectious Diseases at Imperial College London and Director of Infection Prevention and Control at Imperial College Healthcare NHS Trust, is leading a newly created centre to tackle drug-resistant infections. She was speaking at the Imperial College Academic Health Science Centre (AHSC) seminar earlier this month at Hammersmith Hospital, part of Imperial College Healthcare NHS Trust.

Overuse of antibiotics or using them for the wrong reason is fuelling antimicrobial resistance (AMR), leading to an increase in drug-resistant infections. AMR occurs when the microorganisms that cause infections such as bacteria and fungi develop resistance to treatments like antibiotics.

AMR is a huge global health concern, as growing numbers of infections – such as tuberculosis, sepsis or those that cause infections in healthcare settings – are becoming harder to treat.

Professor Holmes outlined why it was so important to preserve current antibiotics so infections can be treated effectively. Access to effective antimicrobial drugs (like antibiotics or antifungals) is critical in treating patients with bacterial, fungal and viral infections. However, the development of new drugs is limited, so there is a critical need to optimise the drugs we currently have available.

“We need to do a lot more to tackle drug-resistant infections right now and we cannot wait for new solutions. There needs to be a focus on improving how we use existing agents and we need to understand how to better prevent and treat infections. We also need to improve our dosing for patients as our current use of antibiotics is not good enough for our very vulnerable patients.”

The new Centre for Antimicrobial Optimisation (CAMO), which Professor Holmes is leading, aims to support and deliver innovative technologies to optimise the use of antibiotics, antifungals and antivirals to improve patient care and reduce the drivers of drug-resistant infections.

One of CAMO’s aims is to focus on innovations to support tailored prescribing for vulnerable patients.

Currently, antimicrobial prescribing is typically based upon a ‘one dose fits all’ model – where all patients receive the same recommended dose of an antibiotic for an infection. But this approach fails to account for wide variations in how patients respond to the drugs or the nature of their infection. Consequently, treatment is often not as effective as it could be, affecting clinical outcomes and driving AMR.

Professor Holmes talked about how the Centre is addressing the issue of antibiotic prescribing, using emerging technologies, including Artificial Intelligence approaches to support clinical decision-making. One Imperial team is developing microneedle biosensors to monitor and optimise antibiotic treatment. These small, painless patches are worn on the skin and measure the amount of antibiotics in someone’s blood in real time. They are ultimately being developed to provide individualised, responsive dosing to optimise antimicrobial use, improve clinical care and reduce the drivers of antimicrobial resistance.

Professor Holmes was joined in the seminar by Ramesh Wigneshweraraj, Professor of Molecular Microbiology in the Department of Infectious Disease at Imperial College London, who talked about his work on how bacterial viruses can help combat bacteria resistance to antibiotics.

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