Usefulness of C-reactive Protein Testing in Acute Cough/Respiratory Tract Infection: A Case-Control Study in a UK Based GP Population

Abstract

Introduction: 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) and has been adopted into NICE guidelines, but its use in primary care is still controversial. We aimed to evaluate the effect of CRP testing on the prescription of antibiotics and the outcome of patients in general practice with acute cough/RTI. Methods: We undertook a case-control study with POC testing with CRP in intervention group (Oct 16-Jan 17) and compared this to similar cohort of patients from a year previously coded with exact diagnosis. Results: A total of 207 patients were included: 69 in the intervention group and 138 in the control group. The two groups were similar in clinical characteristics. In the intervention group, the antibiotic prescribing rate was 31.6%, which was significantly lower than that in the control group (59.9%) (P=0.003). The recovery rate, as recorded by the GPs, was 94.9% and 93.8% in the intervention and control groups, respectively. Referral to Emergency Department for children under 12 was also reduced significantly in the intervention group (4.4%) when compared to the control group (6.5%; P=0.00479). Conclusion: The study showed that CRP testing in patients with acute cough/RTI may reduce antibiotic prescribing and referral to pediatric ED, probably without compromising recovery.