The CRP finger-prick test could be used in general practice to reduce antibiotic prescribing for patients with chronic obstructive pulmonary disease, researchers have reported.
Patients who are suffering flare-up but have a low C-reactive protein level receive little benefit from antibiotics, according to the UK-based researchers.
According to a study conducted by three medical schools, the CRP test reduced antibiotic prescriptions by 20% – without any ill-effects on patient recovery.
The findings have been published in the New England Journal of Medicine.
Some 653 patients took part in the trial and were randomly assigned to usual care or taking a CRP test.
The study was conducted by researchers at Cardiff University, Oxford University and King’s College, London.
Professor Nick Francis, from Cardiff, said: “This is a patient population that are often considered to be at high risk from not receiving antibiotics, but we were able to achieve a reduction in antibiotic use that is about twice the magnitude of that achieved by most other antimicrobial stewardship interventions, and demonstrate that this approach was safe.”
Professor Chris Butler, from Oxford, added: “This rigorous clinical trial speaks directly to the pressing issues of preserving the usefulness of our existing antibiotics; the potential of stratified, personalised care; the importance of contextually-appropriate evidence about point of care testing in reducing unnecessary antibiotic use, and; enhancing the quality of care for people with the common condition of chronic obstructive pulmonary disease.
“Ours is the first trial of biomarker guided management of AECOPD in ambulatory care and has found an effect that should be practice-changing.”
NEJM 11 July 2019
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