Similar Symptoms, Different Causes

Many illnesses have the same or similar symptoms. For example, respiratory illnesses often come with symptoms like cough and fever, that can be a result of either a bacterial or a viral infection. Less commonly, fungi may cause a respiratory infection, mainly in patients whose immune systems are suppressed or compromised.

There are many different types of disease-causing agents or microorganisms including, but not limited to bacteria, viruses, and fungi, all of which can be generally referred to as pathogens. Each type of pathogen has a specific class of drug that can treat it. Bacterial infections are treated with antibiotics, viral infections are treated with antivirals, and fungal infections are treated with antifungals. The 3 classes of drugs—antibiotics, antivirals, and antifungals—are most effective against their respective pathogens. For example, antibiotics will not be effective for viral infections and visa versa. While there are a lot of antimicrobials available, not all infections have a treatment available.  

Finding the Best Treatment 

Some types of antimicrobials can treat wide ranges of bacteria, viruses, or fungi, and are known as broad-spectrum drugs. Other types of antimicrobials are more specific to a particular pathogen or family of pathogens and are termed narrow-spectrum. While broad-spectrum drugs are very useful in particular situations, they are not always necessary  or even the best choice for treatment. Like any drug, broad-spectrum antimicrobials may have adverse side effects, and those side effects tend to occur more frequently than with a narrow-spectrum drug. Additionally, unnecessary use of broad-spectrum antimicrobials contributes to antimicrobial resistance (AMR), which occurs when a microbe can’t be killed by a drug that was previously effective. Antimicrobial resistance is a problem because it makes it more difficult for doctors to treat infections with the limited number of commercially available antibiotics. Simply put, as antimicrobial resistance increases, the repertoire of available antibiotics decreases

Healthcare providers often prescribe treatment empirically based on preliminary symptoms and immediately available clinical data. While prescribing empirically is a critical part of the treatment process for severe infections, it can also contribute directly to the growing problem of AMR if the right treatment is not prescribed for a patient’s infection. Along with empiric prescription, healthcare providers can order diagnostic tests to identify the causative pathogen. Pathogen identification can potentially assist in determining the most optimal treatment approach and refine the choice of antibiotic to a more narrow-spectrum drug. Through optimizing the treatment course healthcare providers can provide both better patient care and the judicious and responsible use of antimicrobials.

Antimicrobial stewardship (AMS) programs also help combat AMR and improve patient care. AMS is defined as, “coordinated interventions designed to adjust and measure the appropriate use of antibiotic agents by promoting the selection of the optimal antibiotic drug regimen including dosing, duration of therapy, and route of administration.” AMS programs and diagnostics can work together hand-in-hand to support better patient care, lessen the chance of adverse side effects, and minimize the emergence and spread of AMR.

Rapid Testing for More Than One Pathogen at a Time

Diagnostic testing methods can take varying amounts of time to complete and provide results. The method or methods that are used can depend on the type of pathogen being tested, course and severity of illness, as well as test availability.

One method that can be used for multi-pathogen or syndromic testing is multiplex Polymerase Chain Reaction (PCR).  For situations where the illness is severe and symptoms could indicate several different types of infections, using a multiplex PCR testing panel can be helpful, because it can quickly check for a wide range of pathogens at the same time, helping healthcare providers determine the most appropriate treatment. The chemistry involved in this type of process is complex, but it can often provide easily interpretable results within hours, and sometimes less. Especially when a patient is severely ill, the ability to get results quickly can be lifesaving.

Why Diagnostic Testing and the Syndromic Approach are Important

As a parent, it is important to understand how diagnostic tests can help a child with a severe illness. The right tests help doctors make informed treatment decisions. Getting test results quickly means that doctors can provide any needed changes to therapy earlier, which can help save kids’ lives while also preserving the ability of antimicrobial drugs to fight future infections.