TY - JOUR

T1 - Randomised controlled trial of CRP rapid test as a guide to treatment of respiratory infections in general practice

AU - Diederichsen, H Z

AU - Skamling, M

AU - Diederichsen, A

AU - Grinsted, P

AU - Antonsen, S

AU - Petersen, P H

AU - Munck, A P

AU - Kragstrup, J

PY - 2000/3

Y1 - 2000/3

N2 - OBJECTIVE: To assess whether the frequency of antibiotic prescriptions to patients with respiratory infections is reduced when general practitioners (GPs) use a C-reactive protein (CRP) rapid test in support of their clinical assessment, and to study whether using the test will have any effect on the course of diseaseDESIGN: Randomised controlled trial.SETTING: 35 general practices, County of Funen, Denmark.PATIENTS: 812 patients with respiratory infection.MAIN OUTCOME MEASURES: Frequency of antibiotic prescriptions and morbidity 1 week after the consultation, as stated by the patients.RESULTS: In the CRP group the frequency of antibiotic prescriptions was 43% (179/414) compared with 46% (184/398) in the control group (odds ratio (OR) = 0.9, NS). After 1 week, increased or unchanged morbidity was stated more frequently in the CRP group (12%) than in the control group (8%) (OR = 1.6, p = 0.05). In the control group, the variable having the greatest influence on whether the GP prescribed antibiotics was the patients' general well-being (OR = 2.9, p < 0.0001), whereas in the CRP group the CRP value had the greatest influence (OR = 1.1 per unit increase (mg/l), p < 0.0001).CONCLUSION: Based on the present study, the use of the CRP rapid test in support of a possible antibiotic treatment for respiratory infections in general practice cannot be recommended.

AB - OBJECTIVE: To assess whether the frequency of antibiotic prescriptions to patients with respiratory infections is reduced when general practitioners (GPs) use a C-reactive protein (CRP) rapid test in support of their clinical assessment, and to study whether using the test will have any effect on the course of diseaseDESIGN: Randomised controlled trial.SETTING: 35 general practices, County of Funen, Denmark.PATIENTS: 812 patients with respiratory infection.MAIN OUTCOME MEASURES: Frequency of antibiotic prescriptions and morbidity 1 week after the consultation, as stated by the patients.RESULTS: In the CRP group the frequency of antibiotic prescriptions was 43% (179/414) compared with 46% (184/398) in the control group (odds ratio (OR) = 0.9, NS). After 1 week, increased or unchanged morbidity was stated more frequently in the CRP group (12%) than in the control group (8%) (OR = 1.6, p = 0.05). In the control group, the variable having the greatest influence on whether the GP prescribed antibiotics was the patients' general well-being (OR = 2.9, p < 0.0001), whereas in the CRP group the CRP value had the greatest influence (OR = 1.1 per unit increase (mg/l), p < 0.0001).CONCLUSION: Based on the present study, the use of the CRP rapid test in support of a possible antibiotic treatment for respiratory infections in general practice cannot be recommended.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Anti-Bacterial Agents/therapeutic use

KW - C-Reactive Protein/analysis

KW - Child

KW - Child, Preschool

KW - Denmark

KW - Drug Utilization Review

KW - Family Practice/methods

KW - Female

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Middle Aged

KW - Practice Guidelines as Topic

KW - Practice Patterns, Physicians'

KW - Reagent Kits, Diagnostic

KW - Respiratory Tract Infections/blood

KW - Treatment Outcome

U2 - 10.1080/02813430050202541

DO - 10.1080/02813430050202541

M3 - Journal article

C2 - 10811042

VL - 18

SP - 39

EP - 43

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

SN - 0281-3432

IS - 1

ER -