BACKGROUND: In clinical trials, the potential of point-of-care (POC) C-reactive protein (CRP) tests was demonstrated in decreasing antibiotic prescribing in adults with acute cough in general practice, but effects of implementation are unknown. OBJECTIVE: To determine the overall effect of POC CRP testing on antibiotic prescribing rate in general practice. METHODS: In an observational study, GPs were instructed to use POC CRP in adults with acute cough following current guidelines. After routine history taking and physical examination, they reported whether they intended to prescribe antibiotics ('pre-test decision'). They reported their revised decision after receiving the POC CRP test result ('post-test decision'). Primary outcome was the percentage of patients in whom the GP changed his or her decision to prescribe antibiotics. Secondary outcome was the difference between 'pre-test' and 'post-test' antibiotic prescribing % at group level. RESULTS: A total of 40 GPs enrolled 939 patients, 78% of whom were tested for CRP. GPs changed their decision after POC CRP testing in 200 patients (27%). Antibiotic prescribing before and after CRP testing did not differ ('pre-test' 31%, 'post-test' 28%; 95% confidence interval of difference -7 to 1). In 41% of the tested patients, the indication for testing was in accordance with the guidelines. CONCLUSION: POC CRP influenced GPs to change their decision about antibiotic prescribing in patients with acute cough. POC CRP testing does not reduce overall antibiotic prescribing by GPs who already have a low antibiotic prescribing rate.
BACKGROUND: In clinical trials, the potential of point-of-care (POC) C-reactive protein (CRP) tests was demonstrated in decreasing antibiotic prescribing in adults with acute cough in general practice, but effects of implementation are unknown. OBJECTIVE: To determine the overall effect of POC CRP testing on antibiotic prescribing rate in general practice. METHODS: In an observational study, GPs were instructed to use POC CRP in adults with acute cough following current guidelines. After routine history taking and physical examination, they reported whether they intended to prescribe antibiotics ('pre-test decision'). They reported their revised decision after receiving the POC CRP test result ('post-test decision'). Primary outcome was the percentage of patients in whom the GP changed his or her decision to prescribe antibiotics. Secondary outcome was the difference between 'pre-test' and 'post-test' antibiotic prescribing % at group level. RESULTS: A total of 40 GPs enrolled 939 patients, 78% of whom were tested for CRP. GPs changed their decision after POC CRP testing in 200 patients (27%). Antibiotic prescribing before and after CRP testing did not differ ('pre-test' 31%, 'post-test' 28%; 95% confidence interval of difference -7 to 1). In 41% of the tested patients, the indication for testing was in accordance with the guidelines. CONCLUSION: POC CRP influenced GPs to change their decision about antibiotic prescribing in patients with acute cough. POC CRP testing does not reduce overall antibiotic prescribing by GPs who already have a low antibiotic prescribing rate.
Authors: Leanne Chalmers; Petra Czarniak; Jeffery Hughes; Rebecca Iacob; Ya Ping Lee; Kiran Parsons; Richard Parsons; Bruce Sunderland; Tin Fei Sim Journal: Explor Res Clin Soc Pharm Date: 2022-06-02
Authors: Veerle Matheeussen; Viviane Van Hoof; Katherine Loens; Christine Lammens; Anouk Vanderstraeten; Samuel Coenen; Chris C Butler; Paul Little; Theo J M Verheij; Herman Goossens; Margareta Ieven Journal: Eur J Clin Microbiol Infect Dis Date: 2018-05-10 Impact factor: 3.267
Authors: Angel M R Schols; Eline Meijs; Geert-Jan Dinant; Henri E J H Stoffers; Mariëlle M E Krekels; Jochen W L Cals Journal: BMJ Open Date: 2019-05-28 Impact factor: 2.692
Authors: Andrea H L Bruning; Wilhelmina B de Kruijf; Henk C P M van Weert; Wim L M Willems; Menno D de Jong; Dasja Pajkrt; Katja C Wolthers Journal: Fam Pract Date: 2017-09-01 Impact factor: 2.267
Authors: Geert H Groeneveld; Robert J van de Peppel; Margot W M de Waal; Theo J M Verheij; Jaap T van Dissel Journal: Eur J Gen Pract Date: 2019-08-28 Impact factor: 1.904
Authors: Matthew Johnson; Liz Cross; Nick Sandison; Jamie Stevenson; Thomas Monks; Michael Moore Journal: BMJ Open Date: 2018-10-25 Impact factor: 2.692