RT Journal Article
SR Electronic
T1 Point-of-care C-reactive protein to assist in primary care management of children with suspected non-serious lower respiratory tract infection: a randomised controlled trial
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen18X101600
DO 10.3399/bjgpopen18X101600
A1 Marjolein JC Schot
A1 Ann Van den Bruel
A1 Berna DL Broekhuizen
A1 Jochen WL Cals
A1 Eveline A Noteboom
A1 Walter Balemans
A1 Rogier M Hopstaken
A1 Sanne van Delft
A1 Niek J de Wit
A1 Theo JM Verheij
YR 2018
UL http://bjgpopen.org/content/early/2018/07/09/bjgpopen18X101600.abstract
AB Background Overprescription of antibiotics for lower respiratory tract infections (LRTIs) in children is common, partly due to diagnostic uncertainty, in which case the addition of point-of-care (POC) C-reactive protein (CRP) testing can be of aid.Aim To assess whether use of POC CRP by the GP reduces antibiotic prescriptions in children with suspected non-serious LRTI.Design & setting An open, pragmatic, randomised controlled trial in daytime general practice and out-of-hours services.Method Children between 3 months and 12 years of age with acute cough and fever were included and randomised to either use of POC CRP or usual care. Antibiotic prescription rates were measured and compared between groups using generalising estimating equations.Results There was no statistically significant reduction in antibiotic prescriptions in the GP use of CRP group (30.9% versus 39.4%; odds ratio [OR] 0.6; 95% confidence interval [CI] = 0.29 to 1.23). Only the estimated severity of illness was related to antibiotic prescription. Forty-six per cent of children had POC CRP levels <10mg/L.Conclusion It is still uncertain whether POC CRP measurement in children with non-serious respiratory tract infection presenting to general practice can reduce the prescription of antibiotics. Until new research provides further evidence, POC CRP measurement in these children is not recommended.