Point-of-Care C-Reactive Protein Testing and Antibiotic Prescribing for Respiratory Tract Infections: A Randomized Controlled Trial

Jochen W. L. Cals*, Marjolein J.C. Schot, Sanne A. M. de Jong, Geert-Jan Dinant, Rogier M. Hopstaken

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

123 Citations (Web of Science)

Abstract

PURPOSE Antibiotics are only beneficial for subgroups of patients with acute lower respiratory tract infections (LRTI) and rhinosinusitis in family practice, yet overprescribing for these conditions is common. C-reactive protein (CRP) point-of-care testing and delayed prescribing are useful strategies to reduce antibiotic prescribing, but both have limitations. We evaluated the effect of CRP assistance in antibiotic prescribing strategies including delayed prescribing in the management of LRTI and rhinosinusitis. METHODS We conducted a randomized controlled trial in which 258 patients were enrolled (107 LRTI and 151 rhinosinusitis) by 32 family physicians. Patients were individually randomized to CRP assistance or routine care (control). Primary outcome was antibiotic use after the index consultation. Secondary outcomes included antibiotic use during the 28-day follow-up, patient satisfaction, and clinical recovery. RESULTS Patients in the CRP-assisted group used fewer antibiotics (43.4%) than control patients (56.6%) after the index consultation (relative risk [RR] = 0.77; 95% confidence interval [Cl], 0.56-0.98). This difference remained significant during follow-up (52.7% vs 65.1%; RR = 0.81; 95% Cl, 0.62-0.99). Delayed prescriptions in the CRP-assisted group were filled only in a minority of cases (23% vs 72% in control group, P
Original languageEnglish
Pages (from-to)124-133
JournalAnnals of Family Medicine
Volume8
Issue number2
DOIs
Publication statusPublished - 2010

Keywords

  • Respiratory tract infection
  • C-reactive protein
  • family practice

Cite this