Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2014 May 2:15:80.
doi: 10.1186/1471-2296-15-80.

Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group

Elena Andreeva  1 , Hasse Melbye
Affiliations
Randomized Controlled Trial

Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group

Elena Andreeva et al. BMC Fam Pract. .

Abstract

Background: Point of care testing for C-reactive protein (CRP) has shown promise as a measure to reduce unnecessary antibiotic prescribing in respiratory tract infections (RTI), but its use in primary care is still controversial. We aimed to evaluate the effect of CRP testing on the prescription of antibiotics, referral for radiography, and the outcome of patients in general practice with acute cough/RTI.

Methods: An open-cluster randomized clinical trial was conducted, with CRP testing performed in the intervention group. Antibiotic prescribing and referral for radiography were the main outcome measures.

Results: A total of 179 patients were included: 101 in the intervention group and 78 in the control group. The two groups were similar in clinical characteristics. In the intervention group, the antibiotic prescribing rate was 37.6%, which was significantly lower than that in the control group (58.9%) (P=0.006). Referral for chest X-ray was also significantly lower in the intervention group (55.4%) than in the control group (75.6%) (P=0.004). The recovery rate, as recorded by the GPs, was 92.9% and 93.6% in the intervention and control groups, respectively.

Conclusion: The study showed that CRP testing in patients with acute cough/RTI may reduce antibiotic prescribing and referral for radiography, probably without compromising recovery.

Trial registration: The trial was registered in the ClinicalTrials.gov Protocol Registration System (identification number: NCT01794819).

PubMed Disclaimer

Figures

Figure 1
Figure 1
Antibiotic prescribing by confirmed (X-ray) diagnosis in the intervention and control groups. URTI = upper respiratory tract infections, COPD = chronic obstructive pulmonary disease.
Figure 2
Figure 2
Distribution (%) of CRP values by diagnosis in the intervention group. CRP = C-reactive protein.
Figure 3
Figure 3
Frequency (%) of prescribing antibiotics by CRP value in the intervention group. CRP = C-reactive protein.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Goossens H, Ferech M, Vander SR, Elseviers M. Outpatient antibiotics use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365:579–587. doi: 10.1016/S0140-6736(05)17907-0. - DOI - PubMed
    1. European Antimicrobial Resistance Surveillance System. EARSS annual report 2007. Bilthoven, Netherlands: National Institute for Public Health and the Environment; 2008.
    1. Woodhead M. New guidelines for the management of adult lower respiratory tract infections. Eur Respir J. 2011;38:1250–1251. doi: 10.1183/09031936.00105211. - DOI - PubMed
    1. Butler CC, Hood K, Verheij T, Little P, Melbye H, Nuttall J, Kelly MJ, Mölstad S, Godycki-Cwirko M, Almirall J, Torres A, Gillespie D, Rautakorpi U, Coenen S, Goossens H. Variation in antibiotic prescribing and its impact on recovery in patients with acute cough in primary care: prospective study in 13 countries. BMJ. 2009;338:b2242. doi: 10.1136/bmj.b2242. - DOI - PMC - PubMed
    1. State Budget Institution of Health of Arkhangelsk region “Medical Information and Analytical Center”. The State report on the level of health of the population of the Arkhangelsk Region in 2008. Arkhangelsk; 2009. [In Russian.] ГБУЗ АО “МИАЦ”: Государственный доклад о состоянии здоровья населения Архангельской области в 2008.; г. Архангельск, 2009.

Publication types

Associated data