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Monday 18 December 2017
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Quick test cuts GP antibiotic use, study suggests

To reduce antibiotic prescribing in general practice, use C-reactive protein testing on patients with a chesty cough, a study that will be presented today at the Royal College of General Practice (RCGP) annual conference in Glasgow revealed

To reduce antibiotic prescribing in general practice, use C-reactive protein testing on patients with a chesty cough, a study that will be presented today at the Royal College of General Practice (RCGP) annual conference in Glasgow revealed.

This is a blood test that measures the amount of C-reactive protein in the blood, and can show general levels of inflammation in your body - though not where the inflammation is, or the cause. The test is done to check for infection after surgery and identify/keep track of infections and diseases that cause inflammation.

The study included 99 patients, aged  five to75 years who visited their GP with a chesty cough. After undergoing a clinical scoring system, each patient’s CRP levels were measured at the point of care using the Alere AfinionTM CRP test. Only 13% of these patients needed antibiotic treatment as the CRP point of care testing (POCT) had concluded higher CRP levels. Within one month, 17% of the 99 patients returned to the surgery and only 5% were prescribed antibiotics.

In response to the findings Dr Rob Cook, a GP from London who was involved in the study, said: "This study was conducted to see how feasible and useful CRP POCT is in real world general practice. We found that the test could be easily incorporated into routine care and provided very useful information for GPs and patients presenting with a cough. The vast majority of patients were reassured by a low CRP level and did not receive antibiotics.”

He continued: “NICE has recommended POCT in primary care for lower respiratory tract infections and advises it is considered after clinical assessment as it can reduce use of antibiotics. But it is acknowledged that real life experience in the UK is limited and so was uncertain what the impact might be for work flow in the GP setting. Reducing antimicrobial resistance is becoming a national priority for all healthcare systems. By using CRP POCT GPs can play their part in this and further promote rational prescribing of antibiotics."

Almost 80% of antibiotics are prescribed in primary care, and respiratory tract infections are behind 60% of these prescriptions. The vast majority of these infections are self-limiting or caused by viruses in which case antibiotics have little or no clinical benefit for patients.