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Observational Study
. 2016 May 12;6(5):e011231.
doi: 10.1136/bmjopen-2016-011231.

Out-of-hours antibiotic prescription after screening with C reactive protein: a randomised controlled study

Ingrid Keilegavlen Rebnord  1 , Hogne Sandvik  2 , Anders Batman Mjelle  3 , Steinar Hunskaar  1
Affiliations
Observational Study

Out-of-hours antibiotic prescription after screening with C reactive protein: a randomised controlled study

Ingrid Keilegavlen Rebnord et al. BMJ Open. .

Erratum in

Abstract

Objective: To evaluate the effect of preconsultation C reactive protein (CRP) screening on antibiotic prescribing and referral to hospital in Norwegian primary care settings with low prevalence of serious infections.

Design: Randomised controlled observational study at out-of-hours services in Norway.

Setting: Primary care.

Participants: 401 children (0-6 years) with fever and/or respiratory symptoms were recruited from 5 different out-of-hours services (including 1 paediatric emergency clinic) in 2013-2015.

Intervention: Data were collected from questionnaires and clinical examination results. Every third child was randomised to a CRP test before the consultation; for the rest, the doctor ordered a CRP test if considered necessary.

Outcome measures: Main outcome variables were prescription of antibiotics and referral to hospital.

Results: In the group pretested with CRP, the antibiotic prescription rate was 26%, compared with 22% in the control group. In the group pretested with CRP, 5% were admitted to hospital, compared with 9% in the control group. These differences were not statistically significant. The main predictors for ordering a CRP test were parents' assessment of seriousness of the illness and the child's temperature. Paediatricians ordered CRP tests less frequently than did other doctors (9% vs 56%, p<0.001).

Conclusions: Preconsultation screening with CRP of children presenting to out-of-hours services with fever and/or respiratory symptoms does not significantly affect the prescription of antibiotics or referral to hospital.

Trial registration number: NCT02496559; Results.

Keywords: C-reactive protein; PRIMARY CARE; Prescriptions; Referral and Consultation.

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Figures

Figure 1
Figure 1
Flow chart over included and investigated patients in the study. CRP, C reactive protein; OOH, out-of-hours.
See this image and copyright information in PMC

References

    1. Rebnord IK, Sandvik H, Hunskaar S. Use of laboratory tests in out-of-hours services in Norway. Scand J Prim Health Care 2012;30:76–80. 10.3109/02813432.2012.684208 - DOI - PMC - PubMed
    1. Theodoratou E, Johnson S, Jhass A et al. . The effect of Haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence, severe morbidity and mortality. Int J Epidemiol 2010;39(Suppl 1):i172–85. 10.1093/ije/dyq033 - DOI - PMC - PubMed
    1. Magnus MC, Vestrheim DF, Nystad W et al. . Decline in early childhood respiratory tract infections in the Norwegian mother and child cohort study after introduction of pneumococcal conjugate vaccination. Pediatr Infect Dis J 2012;31:951–5. 10.1097/INF.0b013e31825d2f76 - DOI - PMC - PubMed
    1. NORM/NORM-VET. Usage of antimicrobial agents and occurrence of antimicrobial resistance in Norway. Norwegian surveillance system for antimicrobial resistance (NORM) and Norwegian surveillance system for antimicrobial resistance in veterinary and food production sectors (NORM-VET). Norwegian Veterinary Institute, 2013.
    1. Sakshaug S, ed. Drug Consumption in Norway 2009–2013 (Legemiddelforbruket i Norge 2009–2013), Norwegian Institute of Public Health, Oslo, legemiddelstatistikk 2014:1.

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