On-the-Spot Testing Reduces Unnecessary Antibiotics

Fast, on-the-spot, diagnostic biomarker tests for bacterial infections may help to reduce excessive antibiotic use, according to a new review.

Researchers at the University of Copenhagen (Denmark) and The Nordic Cochrane Center (Copenhagen, Denmark) conducted a systematic review of six randomized trials on use of the C-reactive protein (CRP) test in a total of 3,284 predominantly adult patients with acute respiratory infections, of whom 1,416 were prescribed antibiotics. The CRP test is currently the only on-the-spot kit available to general practitioners intended to guide antibiotic prescription.

The results showed that antibiotic use was 22% lower in the group who took the CRP test. However, the results varied considerably between studies, possibly due to differences in the study design. While the researchers found no difference between the two groups in terms of how long patients took to recover, they did note an increase in hospitalizations in the CRP group in one study, but this was based on few events and the researchers suggest this may be a chance finding. The study was published online on November 6, 2014, in the Cochrane Library.

“These results suggest that antibiotic use in patients with acute respiratory infections could be reduced by carrying out biomarker tests in addition to routine examinations,” concluded lead author Rune Aabenhus, MD, of the department of public health, and colleagues. “A more precise effect estimate is needed to assess the costs of the intervention and compare the use of a point-of-care biomarker to other antibiotic-saving strategies.”

The CRP test is a nonspecific test used to detect tissue injury, bacterial infection, or significant inflammation in a patient suspected of having an acute condition such as pelvic inflammatory disease (PID), chronic inflammatory conditions such as inflammatory bowel disease (IBD), or autoimmune diseases, such as lupus or vasculitis. CRP may sometimes be ordered along with an erythrocyte sedimentation rate (ESR), another test that detects inflammation.

Related Links:
University of Copenhagen
Nordic Cochrane Center