Evidence map›Paper›PMID 20212299›Full record

Trial reportAnnals of family medicine

Point-of-care C-reactive protein testing and antibiotic prescribing for respiratory tract infections: a randomized controlled trial.

Jochen W L Cals, Marjolein J C Schot, Sanne A M de Jong, Geert-Jan Dinant, Rogier M Hopstaken

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
103citing papers in PubMed, 14 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

103 citing papers in PubMed, 14 syntheses or guidelines pooled it.

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  12. Diagnosis of acute rhinosinusitis in primary care: a systematic review of test accuracy.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016
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  13. Clinical presentation and microbiological diagnosis in paediatric respiratory tract infection: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015
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43 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jochen W L CalsDepartment of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands. j.cals@hag.unimaas.nl
Marjolein J C Schot
Sanne A M de Jong
Geert-Jan Dinant
Rogier M Hopstaken

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAntibiotics are only beneficial for subgroups of patients with acute lower respiratory tract infections (LRTI) and rhinosinusitis in family practice, yet overprescribing for these conditions is common. C-reactive protein (CRP) point-of-care testing and delayed prescribing are useful strategies to reduce antibiotic prescribing, but both have limitations. We evaluated the effect of CRP assistance in antibiotic prescribing strategies-including delayed prescribing-in the management of LRTI and rhinosinusitis.

methodsWe conducted a randomized controlled trial in which 258 patients were enrolled (107 LRTI and 151 rhinosinusitis) by 32 family physicians. Patients were individually randomized to CRP assistance or routine care (control). Primary outcome was antibiotic use after the index consultation. Secondary outcomes included antibiotic use during the 28-day follow-up, patient satisfaction, and clinical recovery.

resultsPatients in the CRP-assisted group used fewer antibiotics (43.4%) than control patients (56.6%) after the index consultation (relative risk [RR] = 0.77; 95% confidence interval [CI], 0.56-0.98). This difference remained significant during follow-up (52.7% vs 65.1%; RR = 0.81; 95% CI, 0.62-0.99). Delayed prescriptions in the CRP-assisted group were filled only in a minority of cases (23% vs 72% in control group, P < .001). Recovery was similar across groups. Satisfaction with care was higher in patients managed with CRP assistance (P = .03).

conclusionsCRP point-of-care testing to assist in prescribing decisions, including delayed prescribing, for LRTI and rhinosinusitis may be a useful strategy to decrease antibiotic use and increase patient satisfaction without compromising patient recovery.

Indexed as

C-Reactive ProteinAdultAgedAnti-Bacterial AgentsDrug UtilizationFemaleHumansIntention to Treat AnalysisMaleMiddle AgedNetherlandsPatient SatisfactionPhysicians, FamilyPoint-of-Care SystemsPractice Patterns, Physicians'Respiratory Tract InfectionsAnti-Bacterial AgentsC-Reactive Protein

Identifiers

PMID20212299
PMCPMC2834719

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.