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

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Abstract
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 disease. Design - 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, pp<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.