Narrative review of primary care pointof- care testing (POCT) and antibacterial use in respiratory tract infection (RTI)

Jonathan Cooke*, Christopher Butler, Rogier Hopstaken, Matthew Scott Dryden, Cliodna McNulty, Simon Hurding, Michael Moore, David Martin Livermore

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    76 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)1-10
    Number of pages10
    JournalBMJ Open Respiratory Research
    Volume2
    Issue number1
    DOIs
    Publication statusPublished - 2015

    Bibliographical note

    Publisher Copyright:
    © 2015, BMJ Publishing Group. All rights reserved.

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