The need for rapid fungal diagnostics in the UK
Traditionally in the UK, fungal diagnostic tests are slow, costly and impractical due to the specialised equipment required to carry them out.1 As such, most fungal infections are diagnosed by the clinician identifying a set of symptoms, in part due to them not trusting tests.
people die of fungal infections every year in the UK, and deaths are likely to increase as resistance continues to rise8
Invasive aspergillosis is the most commonly missed infectious diagnosis in intensive care in the UK9
The financial impact of all fungal diseases exceeded £90M in 2002, in the UK. This cost has been rising annually, following the introduction of new antifungal drugs10
A standardised diagnostic approach
A lack of a standardised diagnostic approach, means infections are being treated blind. This is leading to patients being prescribed inappropriate treatments, potentially missing out on antifungal medicines or increasing harmful resistance to antifungal treatments due to over-prescribing.2
For example, fungal lung infections are often diagnosed as TB.5
One study reported the unnecessary usage of antifungal medications in 16% of cases, the wrong choice of treatment in about one-third of cases and suboptimal treatment in about a half of patients11
Source: Adapted from O’Neill J. Tackling drug-resistant infections globally: Final report and recommendations. The review on antimicrobial resistance; London: HM Government and the Wellcome Trust; 2016.
A novel diagnostic-led approach
A new rapid diagnostic-led approach will lead to more accurate and timely treatments,12 therefore reducing the spread of resistance, whilst preserving existing medications.1,5 This will mean:
- Infection can be better managed
- Unnecessary drug prescribing can be avoided
- Reduced burden on nursing time (e.g. drug administration and patient monitoring)
- Enhanced patient recovery – by applying the right treatment drug at the right dose, at the right time, for the right duration with patient monitoring13,1
- Earlier diagnosis and targeted treatment may also reduce cost burdens, whilst improving patient outcomes.14
In one study, total costs were 32% lower for a diagnostic-led strategy versus an empirical approach due to a reduced incidence of adverse events and decreased use of antifungal treatments.14 In another study, it was estimated 41% fewer patients could be treated with antifungal treatments.5
Cost of care
Cost is often thought of as a barrier to using rapid diagnostics, due to upfront outlays. However, this is short-sighted, as rapid diagnostics can lower costs in the long term, due to a reduced incidence of adverse events and mis-use of antifungal treatments.5
Drug-resistant infections are also a large drain on hospital resources.15 Evidence shows patients with a fungal infection will cost £50K more per case, compared to someone with a similar underlying disease, but with no fungal infection.16
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Baseline results of costs and outcomes of diagnostic-led and empirical strategies14
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Reduced drug resistance
Preservation of existing medication
Improved patient care
Potential cost savings
Lab equipment in place