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
| Autor: | Ann Van den Bruel, Theo J M Verheij, Sanne van Delft, Niek J. de Wit, Walter A.F. Balemans, Berna D L Broekhuizen, Rogier M. Hopstaken, Eveline A. Noteboom, Marjolein J C Schot, Jochen W L Cals |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial children law Internal medicine Lower respiratory tract infection Severity of illness Journal Article Medicine Point-of-care CRP testing 030212 general & internal medicine Medical prescription general practice lcsh:R5-920 biology Respiratory tract infections business.industry Research C-reactive protein Odds ratio medicine.disease Confidence interval biology.protein lower respiratory tract infection lcsh:Medicine (General) Family Practice business c reactive protein |
| Zdroj: | BJGP Open, Vol 2, Iss 3 (2018) BJGP Open, 2(3) |
| ISSN: | 2398-3795 |
| Popis: | BackgroundOverprescription 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.AimTo assess whether use of POC CRP by the GP reduces antibiotic prescriptions in children with suspected non-serious LRTI.Design & settingAn open, pragmatic, randomised controlled trial in daytime general practice and out-of-hours services.MethodChildren 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.ResultsThere 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 ConclusionIt 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. |
| Databáze: | OpenAIRE |
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