Thursday, 21 January 2016

Blood test can now tell if antibiotics are needed for infections

A simple blood test can tell within an hour whether antibiotics are needed for throat infections Photo: ALAMY

Doctors may soon be able to perform a simple blood test to check if a patient needs antibiotics

Một số từ vựng cho chủ đề này:
- antibiotic /ˌæn.ti.baɪˈɒt.ɪk/: n, thuốc kháng sinh
- respiratory /rɪˈspɪr.ə.tər.i/ : n, hô hấp
- infection/ɪnˈfek.ʃən/: n, nhiễm trùng
- crucial /ˈkruː.ʃəl/ a, extremedy important or necessary., rất quan trọng
- prescribe /prɪˈskraɪb/ v, give medicine kê toa, liệt kê
- prescription /prɪˈskrɪp.ʃən/ n, toa thuốc
- pressurized /ˈpreʃ.ər.aɪzd/ a, điều áp
- resistance /rɪˈzɪs.təns/ n, sức đề kháng
- lethal /ˈliː.θəl/ a, gây chết người
- strain /streɪn/ a, sự căng thẳng
- circulate /ˈsɜː.kjʊ.leɪt/ v, tuần hoàn, lan truyền, go around
- definitive /dɪˈfɪn.ɪ.tɪv/ a, cuối cùng, hay nhất, chung cuộc
- incredibly /ɪnˈkred.ɪ.bli/ adv, extremedy
- incredibly useful: vô cùng hữu ích
- diagnosis /ˌdaɪ.əɡˈnəʊ.sɪs/ n, chẩn đoán
- accurate /ˈæk.jʊ.rət/ a, exact, correct without any mistakes.
- struck off: v, gạch tên, xóa bỏ
- mainstay: trụ cột, thành phần chính
- inappropriate /ˌɪn.əˈprəʊ.pri.ət/  a, unsuitable, không thích hợp, không phù hợp
- affordable /əˈfɔː.də.bəl/ a, giá cả phải chăng, not expensive 
- dependable a, đáng tin cậy
- curb /kɜːb/ , v, kiềm chế, to control or something limited


A test which can tell if respiratory infections are caused by viruses or bacteria could prove crucial in the fight against antibiotic resistance.
Duke University in the US has discovered that genes react differently when they are working to fight of viruses or bacterial infections.
It means that doctors could take a simple blood test and known within an hour whether they should prescribe antibiotics or not.
Most respiratory infections are caused by viruses, against which antibiotics are completely ineffective. Yet doctors in Britain still write 10 million prescriptions each year for coughs and colds, often because they feel pressurised by patients.
“GPs are under a lot of pressure from patients to prescribe antibiotics, even when we know they are not the most appropriate course of action."
Dr Tim Ballard, Vice Chair for the Royal College of GPs
Health experts have warned that antibiotic resistance could send medicine back to the dark ages, with even the smallest infections proving lethal, and strains of salmonella and E.coli are now circulating in Britain which are resistant to our last line of drugs.
However armed with the new test, doctors could give patients a definitive reason why the drugs will not work. British doctors said NHS patients had formed a 'worrying reliance' on antibiotics and the test would be 'incredibly useful.'
"A respiratory infection is one of the most common reasons people come to the doctor," said lead author Dr Ephraim Tsalik, assistant professor of medicine at Duke Health in North Carolina.
"We use a lot of information to make a diagnosis, but there's not an efficient or highly accurate way to determine whether the infection is bacterial or viral.
“About three-fourths of patients end up on antibiotics to treat a bacterial infection despite the fact that the majority have viral infections. There are risks to excess antibiotic use, both to the patient and to public health."
Antibiotics  Photo: ALAMY
Last year the National Institute for Health and Care Excellence (Nice) said that doctors must stop prescribing antibiotics for minor infections and warned GPs they could even be struck off if they failed to bring the problem under control.
Antibiotics have been the mainstay of treating infections for more than 60 years but although a new infectious disease has been discovered nearly every year over the past 30 years, no new antibiotics have come to market for 15 years.
Nationally 41.6 million antibiotic prescriptions were issued in 2013/14 at a cost to the NHS of £192 million. But a quarter of them are likely to be inappropriate or unnecessary.
Dr Tim Ballard, Vice Chair for the Royal College of GPs, said: “Effective, reliable, point of care testing to determine whether an infection is viral or bacterial would be incredibly useful for GPs and patients, particularly about making a decision as to whether to prescribe antibiotics, or not.
“GPs are under a lot of pressure from patients to prescribe antibiotics, even when we know they are not the most appropriate course of action. Recent research has even shown that GPs receive lower satisfaction scores from patients, if they decide not to prescribe these drugs.
“The fact is, antibiotics can be very effective as long as they are prescribed properly and used appropriately, but as a nation we have developed a worrying reliance on them. Anything that can be done to reduce this should be encouraged so that we can all benefit from antibiotics when we really need them.
“This research is very important as we move forward in developing tests that are both dependable and affordable, and can help curb the global trend of growing resistance to antibiotics. To this end, we also need more research like this, especially based in primary care, as well as the urgent development of new antibiotics to protect the public against emerging bacterial resistance causing infection in the future.
“We also need to work together to ensure that our patients and the public are aware of the risks associated with inappropriate use of antibiotics and how to use them responsibly, to increase the chances of them working when they might really need them.”
The test looks for genetic signatures in a patient’s blood to indicated whether someone is fighting off an infection from a virus or bacteria. It was found to be 87 per cent accurate in classifying more than 300 patients with flu, the common cold or strep infections.
More precise ways of distinguishing infections could not only reduce unnecessary use of antibiotics, but also lead to more precise treatments of viruses.
"The ideal scenario, should this test ultimately be approved for broad use, is you would go to the doctor's office and receive your results by the time you meet with your provider," said senior Dr Christopher Woods, professor of medicine and associate director of Duke's genomics center.
"We are working to develop a test that could be run in most clinical labs on existing equipment. We believe this could have a real impact on the appropriate use of antibiotics and guide the use of antiviral treatments in the future."
Lord O’Neill, Chairman of the government's Review on Antimicrobial Resistance added: “Rapid diagnostics that can help reduce unnecessary use of antibiotics are vital if we are to win the battle against Antimicrobial Resistance.
"It is always encouraging to hear of progress on this front but, as my review on Antimicrobial Resistance has recommended, we need further incentives for diagnostics to expedite their development and uptake.”
The research was published in the journal Science Translational Medicine.
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