Narrative review of primary care point of-care testing (POCT) and antibacterial use in respiratory tract infection (RTI)
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Antimicrobial resistance is a global problem and is
being addressed through national strategies to improve
diagnostics, develop new antimicrobials and promote
antimicrobial stewardship. A narrative review of the
literature was undertaken to ascertain the value of C
reactive protein (CRP) and procalcitonin,
measurements to guide antibacterial prescribing in
adult patients presenting to GP practices with
symptoms of respiratory tract infection (RTI). Studies
that were included were randomised controlled trials,
controlled before and after studies, cohort studies and
economic evaluations. Many studies demonstrated that
the use of CRP tests in patients presenting with RTI
symptoms reduces antibiotic prescribing by 23.3% to
36.16%. Procalcitonin is not currently available as a
point-of-care testing (POCT), but has shown value for
patients with RTI admitted to hospital. GPs and
patients report a good acceptability for a CRP POCT
and economic evaluations show cost-effectiveness of
CRP POCT over existing RTI management in primary
care. POCTs increase diagnostic precision for GPs in
the better management of patients with RTI. CRP
POCT can better target antibacterial prescribing by GPs
and contribute to national antimicrobial resistance
strategies. Health services need to develop ways to
ensure funding is transferred in order for POCT to be
implemented.
being addressed through national strategies to improve
diagnostics, develop new antimicrobials and promote
antimicrobial stewardship. A narrative review of the
literature was undertaken to ascertain the value of C
reactive protein (CRP) and procalcitonin,
measurements to guide antibacterial prescribing in
adult patients presenting to GP practices with
symptoms of respiratory tract infection (RTI). Studies
that were included were randomised controlled trials,
controlled before and after studies, cohort studies and
economic evaluations. Many studies demonstrated that
the use of CRP tests in patients presenting with RTI
symptoms reduces antibiotic prescribing by 23.3% to
36.16%. Procalcitonin is not currently available as a
point-of-care testing (POCT), but has shown value for
patients with RTI admitted to hospital. GPs and
patients report a good acceptability for a CRP POCT
and economic evaluations show cost-effectiveness of
CRP POCT over existing RTI management in primary
care. POCTs increase diagnostic precision for GPs in
the better management of patients with RTI. CRP
POCT can better target antibacterial prescribing by GPs
and contribute to national antimicrobial resistance
strategies. Health services need to develop ways to
ensure funding is transferred in order for POCT to be
implemented.
Date Issued
2015-12
Date Acceptance
2015-04-15
Citation
BMJ Open Respiratory Research, 2015, 2 (1)
ISSN
2052-4439
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open Respiratory Research
Volume
2
Issue
1
Copyright Statement
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
License URL
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000422585400018&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
Subjects
ACUTE COUGH
ANTIBIOTIC USE
BACTERIAL-INFECTION
CLUSTER
COST-EFFECTIVENESS
C-REACTIVE PROTEIN
Life Sciences & Biomedicine
PNEUMONIA
PROCALCITONIN
RESISTANCE
Respiratory System
Science & Technology
UK
Publication Status
Published
Article Number
e000086
Date Publish Online
2015-05-06