Intended for healthcare professionals


Commentary: How to encourage more diagnostics for infectious diseases

BMJ 2016; 354 doi: (Published 07 September 2016) Cite this as: BMJ 2016;354:i4744
  1. John H Powers, professor of clinical medicine
  1. George Washington University School of Medicine, Washington, DC, USA
  1. JPowers3{at}

The right incentives would aid the development of tools to detect disease, says John Powers

Efforts to increase awareness of sepsis without diagnostic tests may increase inappropriate use of antibiotics, causing greater drug related adverse effects and antibiotic resistance.1 Previous campaigns to decrease “time to first antibiotic dose” in pneumonia increased the odds of inappropriate diagnosis by 39%.2

Diagnostics should improve patient outcomes not just detect organisms or disease.3 Inappropriate use can lead to patient harm and rising healthcare costs.4 But lack of diagnostics for sepsis highlights a bigger problem. The dearth of diagnostics for common infections means that patients are often treated empirically based on assumptions about the presence of disease caused by specific pathogens.

Other specialties such as oncology have identified biomarkers that allow doctors to select patients who will benefit and avoid prescribing to those who will not.5 Developing rapid point-of-care diagnostics …

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