[Analysis of the Cochrane review: biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care. Cochrane Database Syst Rev. 2014,11:CD10130]

Abstract

Acute respiratory infections are the most frequent reason for prescribing antibiotics in primary health care. Since most acute respiratory infections are of viral or non-severe bacterial etiology, the use of antibiotics is not beneficial and exposes patients to side effects. In addition, the undifferentiated prescription of this drug group increases antibiotic resistance and promotes: 1. increased costs for health systems; 2. failure to future treatments, increased morbidity and mortality from infectious diseases. In the appropriate clinical setting, the use of biomarkers as point-of-care tests to assess the acute phase response to injury of tissue / organ, is a strategy in the therapeutic management of patients with acute respiratory infections in outpatient context. This Cochrane review compared the prescription of antibiotics to acute respiratory infections based: 1. exclusively in the clinic; 2. Iinn the use of biomarkers as point-of-care tests (eg C-reactive protein). The C-reactive protein in quick test seems to be associated with reduced use of antibiotics, however, there has not been a reduction in the lenght of treatment or the perception of recovery by the patient. There may be an increase of hospitalizations compared with the group of patients without the biomarker use; no mortality was register in either group.