OBJECTIVE: To assess whether the frequency of antibiotic prescriptions to patients with respiratory infections is reduced when general practitioners (GPs) use a C-reactive protein (CRP) rapid test in support of their clinical assessment, and to study whether using the test will have any effect on the course of disease DESIGN: Randomised controlled trial. SETTING: 35 general practices, County of Funen, Denmark. PATIENTS: 812 patients with respiratory infection. MAIN OUTCOME MEASURES: Frequency of antibiotic prescriptions and morbidity 1 week after the consultation, as stated by the patients. RESULTS: In the CRP group the frequency of antibiotic prescriptions was 43% (179/414) compared with 46% (184/398) in the control group (odds ratio (OR) = 0.9, NS). After 1 week, increased or unchanged morbidity was stated more frequently in the CRP group (12%) than in the control group (8%) (OR = 1.6, p = 0.05). In the control group, the variable having the greatest influence on whether the GP prescribed antibiotics was the patients' general well-being (OR = 2.9, p < 0.0001), whereas in the CRP group the CRP value had the greatest influence (OR = 1.1 per unit increase (mg/l), p < 0.0001). CONCLUSION: Based on the present study, the use of the CRP rapid test in support of a possible antibiotic treatment for respiratory infections in general practice cannot be recommended.
RCT Entities:
OBJECTIVE: To assess whether the frequency of antibiotic prescriptions to patients with respiratory infections is reduced when general practitioners (GPs) use a C-reactive protein (CRP) rapid test in support of their clinical assessment, and to study whether using the test will have any effect on the course of disease DESIGN: Randomised controlled trial. SETTING: 35 general practices, County of Funen, Denmark. PATIENTS: 812 patients with respiratory infection. MAIN OUTCOME MEASURES: Frequency of antibiotic prescriptions and morbidity 1 week after the consultation, as stated by the patients. RESULTS: In the CRP group the frequency of antibiotic prescriptions was 43% (179/414) compared with 46% (184/398) in the control group (odds ratio (OR) = 0.9, NS). After 1 week, increased or unchanged morbidity was stated more frequently in the CRP group (12%) than in the control group (8%) (OR = 1.6, p = 0.05). In the control group, the variable having the greatest influence on whether the GP prescribed antibiotics was the patients' general well-being (OR = 2.9, p < 0.0001), whereas in the CRP group the CRP value had the greatest influence (OR = 1.1 per unit increase (mg/l), p < 0.0001). CONCLUSION: Based on the present study, the use of the CRP rapid test in support of a possible antibiotic treatment for respiratory infections in general practice cannot be recommended.
Authors: Alike W van der Velden; Eefje J Pijpers; Marijke M Kuyvenhoven; Sarah K G Tonkin-Crine; Paul Little; Theo J M Verheij Journal: Br J Gen Pract Date: 2012-12 Impact factor: 5.386
Authors: Raymond Oppong; Mark Jit; Richard D Smith; Christopher C Butler; Hasse Melbye; Sigvard Mölstad; Joanna Coast Journal: Br J Gen Pract Date: 2013-07 Impact factor: 5.386
Authors: Marieke B Lemiengre; Jan Y Verbakel; Roos Colman; Tine De Burghgraeve; Frank Buntinx; Bert Aertgeerts; Frans De Baets; An De Sutter Journal: Br J Gen Pract Date: 2018-02-12 Impact factor: 5.386
Authors: Sarah Kg Tonkin-Crine; Pui San Tan; Oliver van Hecke; Kay Wang; Nia W Roberts; Amanda McCullough; Malene Plejdrup Hansen; Christopher C Butler; Chris B Del Mar Journal: Cochrane Database Syst Rev Date: 2017-09-07